social and political groups in village panel survey... · 66 village qustionnaire – part b...

Village Qustionnaire – Part B 60

Social and Political groups in village fpuhkj;jpy; cs;s murpay; kw;Wk; rK:f mikg;g[f;fs;

S.

no

TYPE OF GROUP

How many [……] exist in this

village? [No. of groups – zero

value possible].

,f;fpuhkj;jpy; [……] vj;jid FGf;fs; cs;sd> [ FGf;fspd; vz;zpf;if ? g{$;$pak; rhj;jpak; ]

What are the names of all groups and organizations in the village? fpuhkj;jpy; cs;s midj;J FGf;fs; kw;Wk; midj;J mikg;g[f;fspd;

bgau;fs; vd;bdd;d>

385. 386.

1.

Self help group(SHG) for

women only

bgz;fSf;fhd Ra cjtpf; FGf;fs; (list name of the

organization and Bank / MFI

Linked to Group affiliated)

(m’;fPfupf;fg;gl;l FGf;fSld; ,izf;fg;gl;Ls;s epWtd’;fs;-t’;fpfs; kw;Wk; FW epjp epWtd’;fspd; bgau;fisg; gl;oayplt[k;)

Group Name

FGtpd; bgau; Linked Bank or

MFI

,izf;fg;gl;l t’;fp my;yJ FW epjp epWtdk;

CODE

FwpaPL

2.

Other Self help group (SHG)

kw;w Ra cjtpf; FGf;fs;

Group Name

FGtpd; bgau; Linked Bank or

MFI

,izf;fg;gl;l t’;fp my;yJ FW epjp epWtdk;

CODE

FwpaPL

3.

Mothers’ Committee

/Magalir Sangam

jha;khu;fs; mikg;g[ - kfspu; r’;fk;

4.

Non government

organization

(NGO)

muR rhuh bjhz;L epWtdk; epWtdk; (list specific names)

(bgah;fis tupirahf Fwpf;ft[k;)

5.

Religious group

Md;kPf FGf;fs; (list groups)

(FGf;fis gl;oayplt[k;)

Name of group

FGtpd; bgau; Religion

kjk; Religion

Code

kjj;jpd; FwpaPL


S.

no

TYPE OF GROUP

How many [……] exist in this

village? [No. of groups – zero

value possible].

,f;fpuhkj;jpy; [……] vj;jid FGf;fs; cs;sd> [ FGf;fspd; vz;zpf;if ? g{$;$pak; rhj;jpak; ]

What are the names of all groups and organizations in the village? fpuhkj;jpy; cs;s midj;J FGf;fs; kw;Wk; midj;J mikg;g[f;fspd;

bgau;fs; vd;bdd;d>

385. 386.

6.

Political parties

murpay; fl;rpfs; (list parties)

(fl;rpfis gl;oayplt[k;;)

Name of Party

fl;rpapd; bgau; Party CODE

fl;rpapd; FwpaPL

7.

Caste Associations

$hjp r’;f’;fs; Name of Group

FGtpd; bgau; Caste

$hjp Caste

(Jati)

CODE

$hjp (FwpaPL)

8.

Village Development

Committee

fpuhk nkk;ghl;Lf; FG

9.

Village Tribal Development

Agency

fpuhk gH’;Fo nkk;ghl;L epWtdk;

10.

Village Education

Committee

fpuhk fy;tpf; FG

11.

Committees on Irrigation and water

use or Water Users Association or

Watershed Committee

ghrdk; kw;Wk; jz;zPu; gad;ghl;ow;fhd fkpl;ofs; my;yJ jz;zPu; gad;gLj;Jnthupd; r’;fk; my;yJ ePh; gfph;t[f;fhd thl;lu;b&l; fkpl;o

12.

Cooperatives

Tl;Lwt[r; r’;f’;fs; (list specific names)

(Fwpg;gpl;l bgah;fisg; gl;oayplt[k;)

13.

Business associations

tu;j;jf r’;f’;fs; (list specific names)

(Fwpg;gpl;l bgah;fisg; gl;oayplt[k;)

14.

Others (Specify)

kw;wit (Fwpg;gplt[k;)

15.

Others (Specify)



BANKS / MFIs – Code t’;fpfs; - FW epjp epWtd’;fspd; ? FwpaPL

Options Code Allahabad Bank my\hghj; t’;fp 01 Andhra Bank Me;jpuh t’;fp 02

Bank of Baroda ng’;f; M`g; gnuhlh 03

Bank of India ng’;f; M`g; ,e;jpah 04

Bank of Maharashtra ng’;f; M`g; k\huh&;;l;uh 05

Canara Bank fduh ng’;f; 06 Central Bank of India brd;l;uy; ng’;f; M`g; ,e;jpah 07 Corporation bank fhh;g;gnu&d; ng’;f; 08 Dena Bank njdh t’;fp 09

ICICI IrpIrpI 10 Indian Bank ,e;jpad; ng’;f; 11

Indian Overseas Bank ,e;jpad; Xtu;rP!; ng’;f; 12

Karur Vysya Bank fU:u; it!;ah t’;fp 13

Oriental Bank of Commerce Xupaz;ly; ng’;f; M`g; fhku;!; 14

Punjab and Sind Bank g”;rhg; mz;l; rpe;J ng’;f; 15

Punjab National Bank g”;rhg; ne&dy; ng’;f; 16

State Bank of India !;nll; ng’;f; M`g; ,e;jpah 17 Syndicate Bank rpz;onfl; ng’;f; 18 Tamilnad Mercantile bank jkpH;ehL bku;f;fz;ily; ng’;f; 19

UCO bank a{nfh ng’;f; 20 Union Bank of India a{dpad; ng’;f; M`g; ,e;jpah 21

United Bank of India a[idl;bll; ng’;f; M`g; ,e;jpah 22

Vijaya Bank it!;ah ng’;f; 23

Other Bank (Specify) kw;w t’;fpfs; (Fwpg;gplt[k;) 24

Activist for Social Alternatives (ASA) rK:f khw;w’;fSf;fhd eltof;iff; FG 25

Bullock cart Workers Development Association(BWDA) khl;L tz;o bjhHpyhsu;fs; nkk;ghl;L mikg;g[ 26

Community Action for Rural Development(CARD) fpuhk nkk;ghl;L rK:f eltof;if 27

Ecumenical Church Loan Fund of India(ECLOF) vf;a{bkdpf;fy; ru;r; nyhd; `gd;L M`g; ,e;jpah 28

Guidance Society for Labour Orphans &

Women(GLOW)

CHpau;fs;. mdhij kw;Wk; bgz;fSf;fhd tHpfhlLk; mikg;g[ (f;nsh)

29

Indian Association for Saving & Credit(IASC) nrkpg;g[ kw;Wk; flDf;fhd ,e;jpa mikg;g[ (IVv!;rp) 30

Integrated Village Development Project(IVDP) xU’;fpize;j fpuhk nkk;ghl;L jpl;lk; (Itpogp) 31

Kalanjiam Development Financial Services (KDFS) fs”;rpak; nkk;ghl;L epjp nrit 32 Kalrayan Hills ADP(KHADP) fy;tuhad; kiy gFjp nkk;ghl;Lj; jpl;lk; 33 League for Education & Development(LEAD) fy;tp kw;Wk; nkk;ghl;L xU’;fpize;j FG[ 34

MAHASEMAM k\hnrkk; 35 Micro Finance Consulting Group(MCG) FW epjp Mnyhrid FG 36

Nanayasurabhi Development Financial Services(NDFS) ehza Rugp nkk;ghl;L epjp nritfs; 37

NEW LIFE g[J thH;t[ 38 OAZOANE(The Society for Development of Human

Abilities and Environment)

Xnrhd; (kzpj jpwikfisa[k; Rw;Wf; R{Hiya[k; nkk;gLj;Jk; r’;fk;)

39

PIONEER TRAD gadPu; onul; 40

PREPARE g;uPngu; 41

Samam Makalir Suyasarbu Iyakkam rkk; kfspu; Ra rhh;g[ ,af;fk; 42 Sarvodaya Nano Finance Ltd. (SNF) ru;nthjah ehndh epjp epWtdk; 43 Semam Micro Finance Investment Literacy &

Empowerment Ltd. (SMILE)

nrkk; FW epjp fy;tp KjyPL kw;Wk; jpwd; btspg;ghL epWtdk;

44

Serva Jana Seva Kosh Ltd. (SJSK) nru;th $d nrth nfh&; ypl; 45

Seva Mahalir Sangamam nrth kfspu; r’;fk; 46 Thirumalai Charity Trust (TCT) jpUkiy rhupl;o ou!;l; 47 Other MFI (Specify) kw;w FW epjp epWtd’;fs; (Fwpg;gplt[k;) 48

Religion Code kjj;jpd; FwpaPL Options Code

Hinduism ,e;J kjk; 01

Islam ,!;yhk; 02

Christianity fpU!;Jtk; 03

Sikhism rPf;fpak; 04

Jainism i$dk; 05

Buddhism bgsj;jk; 06

Zoroastrianism (Parsi) ghh;rp 07

Others____________ kw;wit 08


Political party Code murpay; fl;rp FwpaPLmurpay; fl;rp FwpaPLmurpay; fl;rp FwpaPLmurpay; fl;rp FwpaPL Options Code

All India Anna Dravida Munnetra Kazhagam

(AIADMK)

midj;jpe;jpa mz;zh jpuhtpl Kd;ndw;wf; fHfk; 01

Bharatiya Janata Party (BJP) ghujpa $djh fl;rp 02

Communist Party of India (CPI) ,e;jpa fk;a{dp!;l; fl;rp 03

Communist Party of India (Marxist) (CPI-M) khu;f;!pa fk;a{dp!;l; fl;rp 04

Dravida Munnetra Kazhagam (DMK) jpuhtpl Kd;ndw;w fHfk; 05

Indian National Congress (INC) ,e;jpa njrpa fh’;fpu!; 06

Marumalarchi Dravida Munnetra Kazhagam

(MDMK)

kWkyu;r;rp jpuhtpl Kd;ndw;wf; fHfk; 07

Pattali Makkal Katchi (PMK) ghl;lhsp kf;fs; fl;rp 08

All India Forward Bloc (Subhasist) mfpy ,e;jpa `ghh;thu;l; gpshf; (Rgh&p!k;) 09

Democratic Forward Bloc. $dehaf `ghh;thh;l; gpshf; 10

Puthiya Tamilagam g[jpa jkpHfk; 11

Dalit Panthers of India (DPI) or Viduthalai

Siruthaigal

tpLjiy rpWj;ijfs; 12

Muslim League K!;yPk; yPf; 13

Dhesiya Murtpokku Dravida Kazhagam

(DMDK)

njrpa Kw;nghf;F jpuhtpl fHfk; 14

All India Samathuva Makkal Katchi midj;jpe;jpa rkj;Jt kf;fs; fl;rp 15

Others___________ kw;wit 16

Others___________ kw;wit 17


Election Summary: GP election and villages

njh;jy; gw;wpa tpgu’;fs; : fpuhk g”;rhaj;J njh;jy; kw;Wk; fpuhk’;fs; When were the elections

held?

njh;jy; vg;nghJ eilbgw;wJ>

No. of villages represented

by [ ]?

(/////) ?y; g’;bfLj;Jf;bfhz;l fpuhk’;fspd;

vz;zpf;if vd;d>

Number of members of

Panchayat?

g”;rhaj;J cWg;gpdu;fspd; vz;zpf;if vd;d>

Total number of eligible voters in this

panchayat ,e;j g”;rhaj;jpy; jFjp bgw;w thf;fhsu;fspd; vz;zpf;if vd;d>

Total Votes polled gjpthd thf;Ffspd; bkhj;j vz;zpf;if

Total number of GP

meetings held

bkhj;jk; vj;jid fpuhk g";rhaj;J Tl;l’;fs; eilbgw;wJ>

Total number of gram

sabha meetings held

bkhj;jk; vj;jid fpuhkrgh Tl;l’;fs; eilbgw;wJ> Year

tUlk;

YYYY

Month

khjk;

MM

387. 388. 389. 390. 391. 392. 393.

Elections

Oct. 2006

mf;/ 2006 njh;jy;fs;

Panchayat

2001 – 2006

g";rhaj;J 2001 ? 2006

Details of Villages Represented By This Panchayat ,e;j g”;rhaj;jpy; m’;fk; tfpf;Fk; fpuhk’;fspd; tptu’;fs;

SI Number

tupir vz; Name of the village

fpuhkj;jpd; bgau; Distance from this village (km.)

,e;j fpuhkj;jpy; ,Ue;J J}uk; (fp/kP) Q.No 394. 395.

1 (panchayat headquarters)

g”;rhaj;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;J jiyikafk;

2

3

4

5

6

7


CANDIDATE SUMMARY: VOTES POLLED BY EACH CANDIDATE FOR PANCHAYAT PRESIDENT -2006 Panchayat ntl;ghsupd; tpntl;ghsupd; tpntl;ghsupd; tpntl;ghsupd; tptu’;fs; ? tu’;fs; ? tu’;fs; ? tu’;fs; ? g”;rhaj;J jiytu; njh;jypy; g”;rhaj;J jiytu; njh;jypy; g”;rhaj;J jiytu; njh;jypy; g”;rhaj;J jiytu; njh;jypy; xt;bthUxt;bthUxt;bthUxt;bthU ntl;ghsUk; bgw;w Xl;Lf;fs; ntl;ghsUk; bgw;w Xl;Lf;fs; ntl;ghsUk; bgw;w Xl;Lf;fs; ntl;ghsUk; bgw;w Xl;Lf;fs; = = = = mf;nlhgu; 2006 g”;rhaj;J nju;jy;mf;nlhgu; 2006 g”;rhaj;J nju;jy;mf;nlhgu; 2006 g”;rhaj;J nju;jy;mf;nlhgu; 2006 g”;rhaj;J nju;jy;

CANDIDATE SUMMARY: Panchayat elections

ntl;ghsu;fspd; tptu’;fs; ? g”;rhaj;J nju;jy;;

October 2006 Panchayat President mf;nlhgu; 2006 g”;rhaj;J mf;nlhgu; 2006 g”;rhaj;J mf;nlhgu; 2006 g”;rhaj;J mf;nlhgu; 2006 g”;rhaj;J jiytu;jiytu;jiytu;jiytu;nju;jy;nju;jy;nju;jy;nju;jy;

Within village support based

on …

(///////) mog;gilapy; fpuhkj;jpy;;;;; cs;stu;fspd; Mjut[ ( Muliple response possible

Xd;Wf;F nkw;gl;l gjpy; tuyhk;

outside support based on

(…..)

(///////) mog;gilapy; fpuhkj;jpw;F btspapy; cs;sth;fspd; Mjut[ Muliple response possible


Mode of election

1=direct election;

2=unopposed njh;jy; Kiw ? 01 ? neuoj; njh;jy; 02 ? vjpu; nghl;oapy;yhky; njh;t[

Total

number of

votes polled

gjpthd thf;Ffspd; bkhj;j vz;zpf;if

Total number

of votes

received by

this candidate

,e;j ntl;ghsh; bgw;w thf;Ffspd; bkhj;j vz;zpf;if

Does this

person live in

the village?

mtu; ,e;j fpuhkj;jpy; trpf;fpd;whuh>

If yes, HH

ID

Mk; vdpy;. FLk;g milahs vz;

MEMBER

ID

cWg;gpdu; milahs vz;

Candidate NAME

nghl;oapl;lth; bgah;

Gender

ghypdk; Caste (Jati

NAME]

$hjp (bgau;)

Jati

CODE

$hjp FwpaPL

Religion

kjk; CODE FwpaPL

Caste

(jati)

$hjp

Relig

ion

kjk;

wealthy

person

bry;te;ju;

Caste

(jati)

$hjp

Religion

kjk; Political

party murpay; fl;rp

Yes

Mk; No

,y;iy >NEXT

ROW M

Mz;

F

bgz;

396. 397. 398. 399. 400. 401. 402. 403. 404. 405. 406. 407. 408.

01 02

01 02 03 01 02 03

01 02

01 02

01 02 03 01 02 03

01 02

01 02

01 02 03 01 02 03

01 02

01 02

01 02 03 01 02 03

01 02

01 02

01 02 03 01 02 03

01 02

01 02

01 02 03 01 02 03

01 02

01 02

01 02 03 01 02 03

01 02

01 02

01 02 03 01 02 03

01 02


CANDIDATE SUMMARY: VOTES POLLED BY EACH CANDIDATE FOR PANCHAYAT PRESIDENT – 2001 Panchayat ntl;ghsupd; tptu’;fs; ? g”;rhaj;J jiytu; njh;jypy; xt;bthU ntl;ghsUk; bgw;w Xl;Lf;fs; = mf;nlhgu; 2001 g”;rhaj;J nju;jy;ntl;ghsupd; tptu’;fs; ? g”;rhaj;J jiytu; njh;jypy; xt;bthU ntl;ghsUk; bgw;w Xl;Lf;fs; = mf;nlhgu; 2001 g”;rhaj;J nju;jy;ntl;ghsupd; tptu’;fs; ? g”;rhaj;J jiytu; njh;jypy; xt;bthU ntl;ghsUk; bgw;w Xl;Lf;fs; = mf;nlhgu; 2001 g”;rhaj;J nju;jy;ntl;ghsupd; tptu’;fs; ? g”;rhaj;J jiytu; njh;jypy; xt;bthU ntl;ghsUk; bgw;w Xl;Lf;fs; = mf;nlhgu; 2001 g”;rhaj;J nju;jy;

CANDIDATE SUMMARY: Panchayat elections

ntl;ghsu;fspd;; tptu’;fs; ? g”;rhaj;J nju;jy;fs;;

2001 – 2006 Panchayat –

Previous Panchayat Election (2001 ? 2006 g”;rhaj;J) ? Ke;ija g”;rhaj;J nju;jy;

Within village support

based on …

(///////) mog;gilapy; fpuhkj;jpy;;;;; cs;stu;fspd; Mjut[ ( Muliple response possible


outside support based on

(…..)

(///////) mog;gilapy; fpuhkj;jpw;F btspapy; cs;sth;fspd; Mjut[ Muliple response possible


Mode of

election

1=direct

election;

2=unopposed

njh;jy; Kiw 01 ? neuoj; njh;jy; 02 ? nghl;oapy;yhky; njh;t[

Total

number of

votes

polled

gjpthd bkhj;j thf;Ffspd; vz;zpf;if

Total

number of

votes

received by

this

candidate


Does this

person live in

the village?

mtu; ,e;j fpuhkj;jpy; trpf;fpd;whuh>

If yes,

HH ID

Mk; vdpy;. FLk;g milahs vz;

MEMBER

ID


Candidate

NAME

nghl;oapl;lth; bgah;

Gender

ghypdk; Caste

(Jati

NAME]

$hjp (bgau;)

Jati

CODE

$hjp FwpaPL

Religion

kjk; CODE FwpaPL

Caste

(jati)

$hjp

Religion

kjk; wealthy

person

bry;te;ju;

Caste

(jati)

$hjp

Religion

kjk; Political

party

murpay; fl;rp

Yes

Mk; No

,y;iy >NEXT

ROW M

Mz; F

bgz;

409. 410. 411. 412. 413. 414. 415. 416. 417. 418. 419. 420. 421.

01 02

01 02 03 01 02 03

01 02

01 02

01 02 03 01 02 03

01 02

01 02

01 02 03 01 02 03

01 02

01 02

01 02 03 01 02 03

01 02

01 02

01 02 03 01 02 03

01 02

01 02

01 02 03 01 02 03

01 02

01 02

01 02 03 01 02 03

01 02

01 02

01 02 03 01 02 03

01 02


CANDIDATE SUMMARY: VOTES POLLED BY EACH ELECTED MEMBER, 2006 PANCHAYAT

ntl;ghsupd; tptu’;fs;/ntl;ghsupd; tptu’;fs;/ntl;ghsupd; tptu’;fs;/ntl;ghsupd; tptu’;fs;/; nju;t[ bra;ag;gl;l xt;bthU g”;rhaj;J cWg;gpdUk; ; nju;t[ bra;ag;gl;l xt;bthU g”;rhaj;J cWg;gpdUk; ; nju;t[ bra;ag;gl;l xt;bthU g”;rhaj;J cWg;gpdUk; ; nju;t[ bra;ag;gl;l xt;bthU g”;rhaj;J cWg;gpdUk; bgw;w bgw;w bgw;w bgw;w Xl;Lf;fs;Xl;Lf;fs;Xl;Lf;fs;Xl;Lf;fs; = 2006 = 2006 = 2006 = 2006 g”;rhaj;J nju;jy;g”;rhaj;J nju;jy;g”;rhaj;J nju;jy;g”;rhaj;J nju;jy;

Member's Name

cWg;gpdUila bgau; Number of

candidates contested

for this post

,e;j gjtpf;Fg; nghl;oapl;l ntl;ghsu; fspd; vz;zpf;if

[Mode of election

01=direct election;

02=unopposed

njh;jy; Kiw 01 ? neuoj; njh;jy; 02 ? vjph; nghl;oapy;yhky; njh;t[

Total number of votes

polled


Total number of votes received

by this candidate


Q.no 422. 423. 424. 425. 426.

WARD _____ gFjp

Member 1

cWg;gpdh; 1

Member 2

cWg;gpdh; 2

Member 3

cWg;gpdh; 3

WARD _____

gFjp

Member 1

cWg;gpdh; 1

Member 2

cWg;gpdh; 2

Member 3

cWg;gpdh; 3

WARD _____

gFjp

Member 1

cWg;gpdh; 1

Member 2

cWg;gpdh; 2

Member 3

cWg;gpdh; 3


Member's Name

cWg;gpdUila bgau; Number of candidates contested

for this post

,e;j gjtpf;Fg; nghl;oapl;l tu;fspd; vz;zpf;if

[Mode of election

01=direct election;

02=unopposed

njh;jy; Kiw ? 01 ? neuoj; njh;jy; 02 ? vjph; nghl;oapy;yhky; njh;t[


polled



received by this candidate


WARD _____

gFjp

Member 1

cWg;gpdh; 1

Member 2

cWg;gpdh; 2

Member 3

cWg;gpdh; 3

WARD _____ gFjp

Member 1

cWg;gpdh; 1

Member 2

cWg;gpdh; 2

Member 3

cWg;gpdh; 3

WARD _____

gFjp

Member 1

cWg;gpdh; 1

Member 2

cWg;gpdh; 2

Member 3

cWg;gpdh; 3

WARD _____ gFjp

Member 1

cWg;gpdh; 1

Member 2

cWg;gpdh; 2

Member 3

cWg;gpdh; 3


VOTES POLLED BY EACH ELECTED MEMBER OF 2001-2006 PANCHAYAT ( Previous Panchayat Election)

2001 2001 2001 2001 ???? 2006 2006 2006 2006 g”;rhaj;J nju;jypy;g”;rhaj;J nju;jypy;g”;rhaj;J nju;jypy;g”;rhaj;J nju;jypy; nju;t[ bra;ag;gl;l xt;bthU g”:;rhaj;J cWg;gpdUk; nju;t[ bra;ag;gl;l xt;bthU g”:;rhaj;J cWg;gpdUk; nju;t[ bra;ag;gl;l xt;bthU g”:;rhaj;J cWg;gpdUk; nju;t[ bra;ag;gl;l xt;bthU g”:;rhaj;J cWg;gpdUk; bgw;w bgw;w bgw;w bgw;w Xl;Lf;fs;Xl;Lf;fs;Xl;Lf;fs;Xl;Lf;fs; (((( Ke;ija g”;rhaj;J njuKe;ija g”;rhaj;J njuKe;ija g”;rhaj;J njuKe;ija g”;rhaj;J nju;jy;;jy;;jy;;jy;))))

Member's Name

cWg;gpdUila bgau;

Number of candidates contested for this post


[Mode of election

01=direct election;

02=unopposed

njh;jy; Kiw 01 ? neuoj; njh;jy; 02 ? vjph; nghl;oapy;yhky; njh;t[

Total number of votes polled

gjpthd thf;Fffspd; bkhj;j vz;zpf;if

Total number of votes received by this candidate

,e;j ntl;ghsh; bghw;w thf;Ffspd; bkhj;j vz;zpf;if

Q.no 427. 428. 429. 430. 431.

WARD _____

gFjp

Member 1

cWg;gpdh; 1

Member 2

cWg;gpdh; 2

Member 3

cWg;gpdh; 3

WARD _____

gFjp

Member 1

cWg;gpdh; 1

Member 2

cWg;gpdh; 2

Member 3

cWg;gpdh; 3

WARD _____ gFjp

Member 1

cWg;gpdh; 1

Member 2

cWg;gpdh; 2

Member 3

cWg;gpdh; 3


Member's Name

cWg;gpdUila bgau;

Number of candidates contested

for this post


[Mode of election

01=direct election;

02=unopposed

njh;jy; Kiw ? 01 ? neuoj; njh;jy; 02 ? vjph; nghl;oapy;yhky; njh;t[


polled



received by this candidate

,e;j ntl;ghsh; bgw;w thf;Fffspd; bkhj;jvz;zpf;if

WARD _____

gFjp

Member 1

cWg;gpdh; 1

Member 2

cWg;gpdh; 2

Member 3

cWg;gpdh; 3

WARD _____

gFjp

Member 1

cWg;gpdh; 1

Member 2

cWg;gpdh; 2

Member 3

cWg;gpdh; 3

WARD _____

gFjp

Member 1

cWg;gpdh; 1

Member 2

cWg;gpdh; 2

Member 3

cWg;gpdh; 3

WARD _____ gFjp

Member 1

cWg;gpdh; 1

Member 2

cWg;gpdh; 2

Member 3

cWg;gpdh; 3


DETAILS ABOUT GRAM PANCHAYAT (ELECTED OCT 2006): Note that the filled-in boxes for Panchayat president indicate information already collected in the election summary fpuhk g”;rhaj;J gw;wpa tptu’;fs; (mf; ? 2006 ?y; nju;t[ bra;ag;gl;lJ) Fwpg;g[ ? g”;rhaj;J jiytUf;fhf g”;rhaj;J jiytUf;fhf g”;rhaj;J jiytUf;fhf g”;rhaj;J jiytUf;fhf g{u;j;jp bra;ag;gl;Ls;s bgl;ofSf;F njh;jy; bjhFg;gpy; ,Ue;J Vw;fdnt jfty;fs; nrfupf;fg;gl;Ls;sd

Sl.

No. tupir vz;

Position

bghWg;g[

Name

bgau;

Gender

ghypdk;

Res

erv

atio

n?

[CO

DE

giv

en b

elo

w)

xJf;fPL FwpaPL (fPnH

fhzt[k ;)

From this

village? ,e;j Ciur; nru;e;jtuh>

If yes,

HH ID,

Mk; vdpy;. FLk;g milahs vz; M

EM

BE

R I

D

cWg;gpdu; milahs vz

�4

41;

Caste

$hjp

Caste

Code

$hjp FwpaPL

Ed

uca

tion

cod

e g

iven

bel

ow

fy;;tp FwpaPL fPnH

bfhLf;fg;gl;Ls;sJ

Previously held

same post?

Kd;djhf mnj gjtpia tfpj;jhuh>

Candidate at last

GP election?

fle;j fpuhk g”;rhaj;J nju;jypy;

nghl;oapl;lhuh>

Member of

previous GP?

fle;j fpuhk g”;rhaj;jpd; cWg;gpduh>

Party affiliation

(Refer party

CODES] ve;j fl;rpa[ld; bjhlu;g[

cilatu; (fl;rp FwpaPLfis ghu;f;f)

M

M F

bg

Yes

Mk; No

,y;iy ��439

Yes

Mk; No

,y;iy

Yes

Mk; No

,y;iy Yes

Mk; No

,y;iy

Q.n

o 432. 433. 434. 435. 436. 437. 438. 439. 440. 441. 442. 443. 444.

1 President jiyth; 01 02 01 02 01 02

2 Clerk vGj;ju; 01 02 01 02 01 02 01 02 01 02

WARD ___

gFjp

3 Member 1

cWg;gpdh; 1

01 02

01 02

01 02 01 02 01 02

4 Member 2

cWg;gpdh; 2

01 02

01 02

01 02 01 02 01 02

5 Member 3

cWg;gpdh; 3

01 02

01 02

01 02 01 02 01 02

WARD____ gFjp

6 Member 1

cWg;gpdh; 1

01 02

01 02

01 02 01 02 01 02

7 Member 2

cWg;gpdh; 2

01 02

01 02

01 02 01 02 01 02

8 Member 3

cWg;gpdh; 3

01 02

01 02

01 02 01 02 01 02

WARD ____ gFjp

9 Member 1

cWg;gpdh; 1

01 02

01 02

01 02 01 02 01 02

10 Member 2

cWg;gpdh; 2

01 02

01 02

01 02 01 02 01 02

11 Member 3

cWg;gpdh; 3

01 02

01 02

01 02 01 02 01 02


Sl.

No. tupir vz;

Position

bghWg;g[

Name

bgau;

Gender

ghypdk;

Res

erv

atio

n?

[CO

DE

giv

en b

elo

w)

xJf;fPL FwpaPL (fPnH

fhzt[k ;)

From this


If yes,

HH ID,

Mk; vdpy;. FLk;g milahs vz; M

EM

BE

R I

D

cWg;gpdu; milahs vz

�4

41;

Caste

$hjp

Caste

Code

$hjp FwpaPL

Ed

uca

tion

cod

e g

iven

bel

ow

fy;;tp FwpaPL fPnH

bfhLf;fg;gl;Ls;sJ

Previously held

same post?


Candidate at last

GP election?


nghl;oapl;lhuh>

Member of

previous GP?


Party affiliation

(Refer party



M

M F

bg

Yes

Mk; No

,y;iy ��439

Yes

Mk; No

,y;iy

Yes

Mk; No

,y;iy Yes

Mk; No

,y;iy

WARD ____

gFjp

12 Member 1

cWg;gpdh; 1

01 02

01 02

01 02 01 02 01 02

13 Member 2

cWg;gpdh; 2

01 02

01 02

01 02 01 02 01 02

14 Member 3

cWg;gpdh; 3

01 02

01 02

01 02 01 02 01 02

WARD ____

gFjp

15 Member 1

cWg;gpdh; 1

01 02

01 02

01 02 01 02 01 02

16 Member 2

cWg;gpdh; 2

01 02

01 02

01 02 01 02 01 02

17 Member 3

cWg;gpdh; 3

01 02

01 02

01 02 01 02 01 02

WARD ____ gFjp

18 Member 1

cWg;gpdh; 1

01 02

01 02

01 02 01 02 01 02

19 Member 2

cWg;gpdh; 2

01 02

01 02

01 02 01 02 01 02

20 Member 3

cWg;gpdh; 3

01 02

01 02

01 02 01 02 01 02

WARD ____ gFjp

21 Member 1

cWg;gpdh; 1

01 02

01 02

01 02 01 02 01 02

22 Member 2

cWg;gpdh; 2

01 02

01 02

01 02 01 02 01 02

23 Member 3

cWg;gpdh; 3

01 02

01 02

01 02 01 02 01 02


Reservation code

,lxJf;fPL FwpaPL

Options Code

SC Mjp jpuhtplu;

1

SC Female Mjp jpuhtplu; ? bgz;fs;

2

ST gH’;Foapdu;

3

ST Female gH’;Foapdu; ? bgz;fs;

4

BC / MBC gpd;j’;fpa tFg;g[ - kpft[k; gpd;j’;fpa tFg;g[

5

BC / MBC Female gpd;j’;fpa tFg;g[ - kpft[k; gpd;j’;fpa tFg;g[ ? bgz;fs;

6

Female bgz;fs; 7

Not Reserved xJf;fPL bra;ag;gltpy;;iy

8

Education code fy;tp FwpaPL

Options Code

No education gof;fhjtu; 1

Pre – school Muk;gg; gs;sp 2

Primary School only bjhlf;fg; gs;sp 3

Upper primary school only eLepiyg; gs;sp 4

Secondary/ Higher Secondary school only cau; epiy - nky; epiyg; gs;sp 5

College fy;Y}hp 6

Industrial Training bjhHpw; gapw;rp 7

Vocational Training ifj; bjhHpw; gapw;rp 8

Others (Specify) kw;wit (Fwpg;gplt[k;) 9


Details about gram panchayat (2001-2006): Note that the filled-in boxes for Panchayat President indicate information already collected in the election summary 2001 ?2006 fpuhk g”;rhaj;J gw;wpa tptu’;fs; Fwpg;g[ ? g”;rhajg”;rhajg”;rhajg”;rhaj;J jiytUf;fhf ;J jiytUf;fhf ;J jiytUf;fhf ;J jiytUf;fhf g{u;j;jp bra;ag;gl;Ls;s bgl;ofSf;F . njh;jy; bjhFg;gpy; ,Ue;J Vw;fdnt tptu’;fs; nrfupf;fg;gl;Ls;sd vd;gij ftdpf;ft[k; /

Sl.

No. tupir vz;

Position

bghWg;g[

Name

bgau;

Gender

ghypdk;

Res

erv

atio

n?

[CO

DE

giv

en b

elo

w)

xJf;fPL FwpaPL (fPbH

fhzt[k ;)

From this


If yes,

HH ID,

Mk; vdpy;. FLk;g milahs vz

ME

MB

ER

ID


�4

54

;

Caste

$hjp

Caste

Code

$hjp FwpaPL

Ed

uca

tion

cod

e g

iven

bel

ow

fy;;tp FwpaPL fPnH

bfhLf;fg;gl;Ls;sJ

Previously held

same post?


Candidate at

last GP

election?


nghl;oapl;lhuh>

Member of

previous

GP?


Party

affiliation

(Refer party



M

M F

bg

Yes

Mk; No

,y;iy

�452

Yes

Mk; No

,y;iy Yes

Mk; No

,y;iy Yes

Mk; No

,y;iy

Q.no 445. 446. 447. 448. 449. 450. 451. 452. 453. 454. 455. 456. 457.

1 President jiyth;

01 02 01 02 01 02

2 Clerk vGj;ju; 01 02 01 02 01 02 01 02 01 02

WARD ___

gFjp

3 Member 1

cWg;gpdh; 1

01 02

01 02

01 02 01 02 01 02

4 Member 2

cWg;gpdh; 2

01 02

01 02

01 02 01 02 01 02

5 Member 3

cWg;gpdh; 3

01 02

01 02

01 02 01 02 01 02

WARD____ gFjp

6 Member 1

cWg;gpdh; 1

01 02

01 02

01 02 01 02 01 02

7 Member 2

cWg;gpdh; 2

01 02

01 02

01 02 01 02 01 02

8 Member 3

cWg;gpdh; 3

01 02

01 02

01 02 01 02 01 02

WARD ____ gFjp

9 Member 1

cWg;gpdh; 1

01 02

01 02

01 02 01 02 01 02

10 Member 2

cWg;gpdh; 2

01 02

01 02

01 02 01 02 01 02

11 Member 3

cWg;gpdh; 3

01 02

01 02

01 02 01 02 01 02


Sl.

No. tupir vz;

Position

bghWg;g[

Name

bgau;

Gender

ghypdk;

Res

erv

atio

n?

[CO

DE

giv

en b

elo

w)

xJf;fPL FwpaPL (fPbH

fhzt[k ;)

From this


If yes,

HH ID,

Mk; vdpy;. FLk;g milahs vz

ME

MB

ER

ID


�4

54

;

Caste

$hjp

Caste

Code

$hjp FwpaPL

Ed

uca

tion

cod

e g

iven

bel

ow

fy;;tp FwpaPL fPnH

bfhLf;fg;gl;Ls;sJ

Previously held

same post?


Candidate at

last GP

election?


nghl;oapl;lhuh>

Member of

previous

GP?


Party

affiliation

(Refer party



M

M F

bg

Yes

Mk; No

,y;iy

�452

Yes

Mk; No

,y;iy Yes

Mk; No

,y;iy Yes

Mk; No

,y;iy

WARD ____

gFjp

12 Member 1

cWg;gpdh; 1

01 02

01 02

01 02 01 02 01 02

13 Member 2

cWg;gpdh; 2

01 02

01 02

01 02 01 02 01 02

14 Member 3

cWg;gpdh; 3

01 02

01 02

01 02 01 02 01 02

WARD ____

gFjp

15 Member 1

cWg;gpdh; 1

01 02

01 02

01 02 01 02 01 02

16 Member 2

cWg;gpdh; 2

01 02

01 02

01 02 01 02 01 02

17 Member 3

cWg;gpdh; 3

01 02

01 02

01 02 01 02 01 02

WARD ____

gFjp

18 Member 1

cWg;gpdh; 1

01 02

01 02

01 02 01 02 01 02

19 Member 2

cWg;gpdh; 2

01 02

01 02

01 02 01 02 01 02

20 Member 3

cWg;gpdh; 3

01 02

01 02

01 02 01 02 01 02

WARD ____ gFjp

21 Member 1

cWg;gpdh; 1

01 02

01 02

01 02 01 02 01 02

22 Member 2

cWg;gpdh; 2

01 02

01 02

01 02 01 02 01 02

23 Member 3

cWg;gpdh; 3

01 02

01 02

01 02 01 02 01 02


Reservation code

Options Code

SC Mjp jpuhtplu;

1

SC Female Mjp jpuhtplu; ? bgz;fs;

2

ST gH’;Foapdu;

3

ST Female gH’;Foapdu; ? bgz;fs;

4

BC / MBC gpd;j’;fpa tFg;g[ - kpft[k; gpd;j’;fpa tFg;g[

5

BC / MBC Female gpd;j’;fpa tFg;g[ - kpft[k; gpd;j’;fpa tFg;g[ ? bgz;fs;

6

Female bgz;fs; 7

Not Reserved ,l xJf;fPL ,y;iy

8

Education code

Options Code

No education gof;fhjtu; 1

Pre – school Muk;g gs;sp 2

Primary School only bjhlf;f gs;sp 3

Upper primary school only eLepiy gs;sp 4

Secondary/ Higher Secondary school only cau; epiy - nky; epiy gs;sp 5

College fy;Y}hp 6

Industrial Training bjhHpw; gapw;rp 7

Vocational Training ifj; bjhHpw; gapw;rp 8

Others (Specify) kw;wit (Fwpg;gplt[k;) 9


Revenue & expenditures: Current Panchayat tUkhdk;tUkhdk;tUkhdk;tUkhdk; & brytpd’;fs; ? jw;nghija g”;rhaj;Jbrytpd’;fs; ? jw;nghija g”;rhaj;Jbrytpd’;fs; ? jw;nghija g”;rhaj;Jbrytpd’;fs; ? jw;nghija g”;rhaj;J

458. Village Income and Expenditure Statement – 2004 to 2005 fpuhk tUkhdk; kw;Wk; brytpd’;fs; ml;ltiz ? 2004 ? 2005

Income tut[fs;[tut[fs;[tut[fs;[tut[fs;[ Rs. Ps. Expenses bryt[fs;bryt[fs;bryt[fs;bryt[fs; Rs. Ps.

1. House Tax tPl;L tup 1. Salary Cjpak;

2. Library Tax E}yf tup 2. Travel Conveyance gazg; go

3. Professional Tax bjhHpy; tup 3. Writing material vGJ bghUs;

4. Other taxes ,ju tup ,d’;fs; 4. Street Light – Electricity kpd; fl;lzk; ? bjU tpsf;Ffs;

5. Dangerous and offensive Trade

License fee

nfLk; jP’;Fk; tpistpf;fToa bjhHpy; chpkf; fl;lzk;

5. Motor Pumps – Electricity kpd; fl;lzk; ? tpirg; gk;g[fs;

6. Other Fee

,ju chpk fl;lzk;

6. Electricity - Panchayat Buildings

kpd; fl;lzk; ? Cuhl;rpapd; fl;ol’;fs;

7. Building / Plot License Fee

fl;olk; kw;Wk; kid gphpt[ cupkf; fl;lzk;

7. Maintenance of Wells - Materials

and Labour

fpzW guhkupg;g[ ? bghUl;fs; kw;Wk; Typ

8. Penalties paid to Panchayat

Cuhl;rpapy; tpjpf;fg;gl;l mguhj bjhif

8. Hand Pump maintenance

ifg; gk;g[fs; guhkupg;g[

9. Building lease

fl;ol Fj;jif

9. Water tanks - materials and

Labour

nky; epiy ePh; njf;fj; bjhl;o ? jiukl;l ePh;njf;fj; bjhl;o bghUl;fs; kw;Wk; Typ

10. Market (Shandy) Lease

re;ij Fj;jif

10. Maintenance of Street Lights -

Materials & Labour

bjU tpsf;Ffs; guhkupg;g[ ? bghUl;fs; kw;Wk; Typ

11. Income from Social Forestry /

Tree Tax ku kfNy; bjhif

11. Radio and TV - Materials &

Labour

thbdhyp kw;Wk; bjhiyf;fhl;rp ? bghUl;fs; kw;Wk;; Typ

12. Fishery Tax

kPd; ghrp Fj;jif

12. Public Sanitation - Materials &

labour

bghJ Rfhjhuk; ? bghUl;fs; kw;Wk; Typ

13. Other Leases

,ju tif Fj;jif

13. Social Forestry / Gardens

rK:f fhLfs;- gHj; njhl;l’;fs; - g{‘;fhf;fs;

14. Surcharge on Stamp paper Kj;jpiuj; jhs; kpF tup

14. Panchayat Tank Maintenance

Cuhl;rp Fs’;fs; guhkupg;g[

15. Entertainment Tax

nfspf;if tup

15. Recognised Festival Expenses

m';fPfupf;fg;gl;l jpUtpHh brytpd’;fs; [

16. Head tax jy thp 16. Panchayat Building Maintenance

Cuhl;rp fl;ol guhkupg;g[

17. 2C Tree Tax ku tup (2C gl;lh fl;fzk;)

17. Maintenance of Tools jsthl rhkhd;fs; guhkupg;g[

18. Criminal Penalties Collection

Fw;wtpay; jz;l tNy;

18. Road / Minor Bridges

maintenance rhiyfs; -rpW ghy’;fs; guhkupg;g[

19. Other income from Funds

Allocated ,ju xJf;fg;gl;l epjp tutpdk;

19. Panchayat cremation ground

maintenance

Cuhl;rpapd; RLfhL guhkupg;g[



20. Deposit

itg;g[j; bjhif 20. Library tax – Repaid E}yf tup ? jpUk;g mspj;jy;

21. Matured Deposits

fhyk; fle;j itg;g[j; bjhif

21. Paying off deposits itg;g[ bjhif jpUk;g mspj;jy;

22. State Finance Commission

Subsidy (without condition)

khepy epjp FG khdpak; ( epge;jid ,y;yhj gFjp )

22. Cash Advances

Kd; gzk; tH’;Fjy;

23. Other Subsidies

,ju khdpa’;fs; 23. Miscellaneous expenses

,jur; bryt[fs;

24. Others Specify

_______________________ kw;wit Fwpg;gplt[k;

24. Construction of New Buildings

g[jpa fl;ol’;fs; mikj;jy;

25. Others Specify

__________________ kw;wit Fwpg;gplt[k;

25. Laying of New roads / road

development

g[jpa rhiy mikj;jYk; - nkk;ghL bra;jYk;

26. Others Specify

__________________ kw;wit Fwpg;gplt[k;

26. Construction of New Minor

bridges

g[jpa rpW ghy’;fs; mikj;jy;

27. Others Specify

__________________________ kw;wit Fwpg;gplt[k;

27. Street Light – Extension

bjU tpsf;F tpupt[gLj;Jjy;

28. Others Specify

___________________________ kw;wit Fwpg;gplt[k;

28. Water Pipe – Extension

FoePh; FHha;fs; tphpt[gLj;Jjy;

29. Provision of New Drinking water

facility

g[jpa FoePu; rhjd’;fs; mikj;jy;

30. Purchase of Tools / implements

g[jpa jsthl rhkhd;fs; th’;Fjy;

31. Deposits by Panchayat

Cuhl;rpahy; bra;ag;gLk; KjyPLfs;

32. Other Investment Expenses

,ju K:yjd brytpd’;fs;

33. Others Specify

________________________ kw;wit Fwpg;gplt[k;

34. Others Specify

______________________ kw;wit Fwpg;gplt[k;

35. Others Specify

_______________________ kw;wit Fwpg;gplt[k;

36. Others Specify

______________________ kw;wit Fwpg;gplt[k;

37. Others Specify

_______________________ kw;wit Fwpg;gplt[k;

Total bkhj;jk;

Total bkhj;jk;

in hand/bank ifapUg;g[ - t’;fpapy; ,Ug;g[


Gross Total bgU bkhj;jk;



459. Government Grants, Plan Funds, Namathu Gramam, etc – 2004 to 2005 murh’;f rYiffs;. jpl;l xJf;fPL. ekJ fpuhkk;. ,ju ? 2004?2005

S.no Income tUkhdk;tUkhdk;tUkhdk;tUkhdk; Rs.

1. Government Grants - Subject to Conditions

epge;jidf;F cl;gl;l muR khdpa’;fs; epjp (11 / 12

th Finance Commission Fund 11 / 12 tJ epjpf;FG khdpak;)

2. State Finance Commission Fund

khepy epjpf;FG khdpak; (epge;jidf;F cl;gl;lJ ) 3. Plan Fund (SGRY, PMGRY, Indira Memorial Housing Plan & OTHER PLAN FUNDS)

jpl;l epjp (,e;jpuh epidt[ FoapUg;g[ jpl;lk;. kw;w jpl;l epjp)

4. Drinking water plan

FoePu; jpl;lk;

5. Namathu Gramam (Our Village)

ekJ fpuhkk;

6. Other Plans / Projects ,ju jpl;;lk; ______________________________











460. Village Income and Expenditure Statement – 2005 to 2006 fpuhk tUkhdk; kw;Wk; brytpd’;fs; ml;ltiz ? 2005?2006





4. Other taxes ,ju tup ,d’;fs; 4. Street Light – Electricity

kpd; fl;lzk; ? bjU tpsf;Ffs;


License fee



6. Other Fee

,ju chpkf; fl;lzk;

6. Electricity - Panchayat Buildings

kpd; fl;lzk; ? Cuhl;rpapd; fl;ol’;fs;



7. Maintenance of Wells - Materials

and Labour






9. Building lease fl;ol bjhif


Labour



re;ijf; Fj;jif


Materials & Labour





Labour


12. Fishery Tax kPd; ghrp Fj;jif


labour


13. Other Leases ,ju tif Fj;jif



14. Surcharge on Stamp paper Kj;jpiuj; jhs; kpF thp




nfspf;if tup



16. Head tax jy thp 16. Panchayat Building Maintenance


17. 2C Tree Tax ku tup; (2C gl;lh fl;lzk;)

17. Maintenance of Tools

jsthl rhkhd;fs; guhkupg;g[


Fw;wtpay; jz;l tNy;




Allocated

,ju xJf;fg;gl;l epjp tutpdk;


maintenance


20. Deposit

itg;g[j; bjhif 20. Library tax – Repaid

E}yf tup ? jpUk;g mspj;jy;





21. Paying off deposits

itg;gj;[ bjhif jpUk;g mspj;jy;



khepy epjpf; FG khdpak; ( epge;jid ,y;yhj gFjp )

22. Cash Advances

Kd; gzk; tH’;Fjy;

23. Other Subsidies


,jur; bryt[fs;

24. Others Specify

_______________________ kw;wit Fwpg;gplt[k;

24. Construction of New Buildings


25. Others Specify

__________________ kw;wit Fwpg;gplt[k;


development


26. Others Specify

_____________________ kw;wit Fwpg;gplt[k;


bridges


27. Others Specify

__________________________ kw;wit Fwpg;gplt[k;



28. Others Specify

___________________________ kw;wit Fwpg;gplt[k;


FoePu;f; FHha;fs; tphpt[gLj;Jjy;

29. Provision of New Drinking water

facility


30. Purchase of Tools / implements

g[jpa jsthlr; rhkhd;fs; th’;Fjy;





33. Others Specify

________________________ kw;wit Fwpg;gplt[k;

34. Others Specify

______________________ kw;wit Fwpg;gplt[k;

35. Others Specify

_______________________ kw;wit Fwpg;gplt[k;

36. Others Specify

______________________ kw;wit Fwpg;gplt[k;

37. Others Specify

_______________________ kw;wit Fwpg;gplt[k;

Total bkhj;jk;

Total bkhj;jk;















FoePu; jpl;lk;


ekJ fpuhkk;












462. Village Income and Expenditure Statement – 2006 to 2007 fpuhk tUkhdk; kw;Wk; brytpd’;fs; ml;ltiz ? 2006?2007





4. Other taxes ,ju tup ,d’;fs; 4. Street Light – Electricity

kpd; fl;lzk; ? bjU tpsf;Ffs;


License fee



6. Other Fee

,ju chpk fl;lzk;

6. Electricity - Panchayat

Buildings kpd; fl;lzk; ? Cuhl;rpapd; fl;ol’;fs;



7. Maintenance of Wells -

Materials and Labour






9. Building lease fl;ol bjhif


Labour



re;ij Fj;jif


Materials & Labour





Labour


12. Fishery Tax kPd; ghrp Fj;jif


labour


13. Other Leases ,ju tif Fj;jif



14. Surcharge on Stamp paper Kj;jpiuj; jhs; kpF thp




nfspf;if tup



16. Head tax jy thp

16. Panchayat Building

Maintenance


17. 2C Tree Tax ku tup; (2C gl;lh fl;lzk;)

17. Maintenance of Tools

jsthl rhkhd;fs; guhkupg;g[


Fw;wtpay; jz;l tNy;




Allocated ,ju xJf;fg;gl;l epjp tutpdk;


maintenance


20. Deposit itg;g[j; bjhif 20. Library tax – Repaid

E}yf tup ? jpUk;g mspj;jy;





21. Paying off deposits

itg;g[ bjhif jpUk;g mspj;jy;



khepy epjp FG khdpak; ( epge;jid ,y;yhj gFjp )

22. Cash Advances

Kd; gzk; tH’;Fjy;

23. Other Subsidies


,jur; bryt[fs;

24. Others Specify

_______________________ kw;wit Fwpg;gplt[k;

24. Construction of New

Buildings


25. Others Specify

__________________ kw;wit Fwpg;gplt[k;


development


26. Others Specify

___________ kw;wit Fwpg;gplt[k;


bridges


27. Others Specify

__________________________ kw;wit Fwpg;gplt[k;



28. Others Specify

___________________________ kw;wit Fwpg;gplt[k;


FoePu;f; FHha;fs; tphpt[gLj;Jjy;

29. Provision of New Drinking

water facility


30. Purchase of Tools /

implements

g[jpa jsthl rhkhd;fs; th’;Fjy;





33. Others Specify

________________________ kw;wit Fwpg;gplt[k;

34. Others Specify

______________________ kw;wit Fwpg;gplt[k;

35. Others Specify

_______________________ kw;wit Fwpg;gplt[k;

36. Others Specify

______________________ kw;wit Fwpg;gplt[k;

37. Others Specify

_______________________ kw;wit Fwpg;gplt[k;

Total bkhj;jk;

Total bkhj;jk;















FoePu;;j; jpl;lk;


ekJ fpuhkk;












Nature of work done in the street /colony / Neighbourhoods CURRENT PANCHAYAT Oct 2006-current

rhiy - FoapUg;g[ - mUfhik ,l’;fspy; bra;ag;gl;l ntiyapd; jd;ik ? elg;g[ g”;rhaj;J mf;nlhgu; 2006 elg;g[ (Work undertaken from Oct 2006 to ___________________ [today’s date: dd/mm/YYYY]- either providing the service OR

developing new facility / service OR maintenance activity)

mf;nlhgu; 2006 Kjy; ???????????????????????? nkw;bfhs;sg;gl;l ntiyfs; ( ,d;iwa njjp ehs;-khjk;-tUlk;) ? nrit tH’;Ftjw;fhfnth my;yJ g[jpa trjpfs;- nritfis nkk;gLj;jnth my;yJ guhkupg;g[ ntiyfSf;fhfnth)

Type of Work

ntiyapd; jd;ik

Was this

[TYPE OF

WORK]

undertaken in

this Village

from Oct 2006

to till date? mf;nlhgu; 2006ypUe;J ,d;Wtiu nkw;bfhs;sg;gl;l ,e;j ntiy ,e;j fpuhkj;jpy; eil bgw;wjh>

01 = Yes

Mk; 02 = No

,y;iy

If yes,

what

kind of

work

took

place?

Mk; vdpy;. ve;j tifahd ntiy eilbghw;wJ

01=

new

facility

or

service

01 = g[jpa trjp my;yJ nrit 02=

maint-

enance

02 guhkupg;g[

03=both

03= ,uz;Lk;

Where did the work take place? ,e;j ntiy v’;F eilbgw;wJ> Was that provision / development of new facility / service or maintenance activity? mJ g[jpa trjpfs;-nritfis nkk;gLj;Jtjw;fhdjh-my;yJ guhkupg;g[ eltof;ifah> 01 = Yes, new facility / service developed; 01=Mk;. g[jpa trjpfs;-nritfs; nkk;gLj;jg;gl;lJ 02 = Yes, maintenance activity taken place; 02=Mk;. guhkupg;g[ eltof;iffs; bray;gLj;jg;gl;ld 03 = Both - new facility / service developed & maintenance activity taken place 03=Mk;. ,uz;Lk; g[jpa trjpfs;-nritfis nkk;gLj;j kw;Wk; guhkupg;g[ eltof;iffs; Street-Neighborhood ID

gzp nkw;bfhs;sg;gl;l bjU? mUfhikapy; cs;s miahsgzp nkw;bfhs;sg;gl;l bjU? mUfhikapy; cs;s miahsgzp nkw;bfhs;sg;gl;l bjU? mUfhikapy; cs;s miahsgzp nkw;bfhs;sg;gl;l bjU? mUfhikapy; cs;s miahs vz;vz;vz;vz;

ST

RE

ET

ID

1

bjU milahs vz; 1

ST

RE

ET

ID

2

bjU milahs vz; 2

S

TR

EE

T I

D3

bjU milahs vz; 3

S

TR

EE

T I

D4

bjU milahs vz; 4

S

TR

EE

T I

D5

bjU milahs vz; 5

S

TR

EE

T I

D6

bjU milahs vz; 6

S

TR

EE

T I

D7

bjU milahs vz; 7

Q.no 464. 465. 466.

1. Purity of drinking water

Fo jz;zPiuj; J}a;ikg; gLj;JtJ

2. Supply of drinking water

FoePu; tpepnahfk;

3. Sanitation/ sewage

Rfhjhuk;-fHpt[ ePufw;WtJ

4. Roads

rhiy mikg;gJ

5. Communication Facilities

(e.g. PCO, Post office)

jfty; bjhlu;g[ trjpfs; (ck; gprpX. m”;ry; epiyak;)

6. Local Transport

cs;S:u; nghf;F tuj;J

7. School quality and access

[building schools,

improvement, painting, etc]

gs;spf;Tlj;jpd; juk; kw;Wk; nkk;gLj;Jjy; (gs;spf;Tl’;fs; fl;Ljy; . trjpfis nkk;gLj;Jjy; bgapd;o’; nghd;wit)

8. Health Mnuhf;fpak;

9. Childcare or child facility,

including balwadi

FHe;;ijfs; guhkupg;g[. my;yJ FHe;ijf;fhd trjpfs; . ghy;tho cl;gl


Type of Work

ntiyapd; jd;ik

Was this

[TYPE OF

WORK]

undertaken in

this Village

from Oct 2006

to till date? mf;nlhgu; 2006ypUe;J ,d;Wtiu nkw;bfhs;sg;gl;l ,e;j ntiy ,e;j fpuhkj;jpy; eil bgw;wjh>

01 = Yes

Mk; 02 = No

,y;iy

If yes,

what

kind of

work

took

place?

Mk; vdpy;. ve;j tifahd ntiy eilbghw;wJ

01=

new

facility

or

service

01 = g[jpa trjp my;yJ nrit 02=

maint-

enance

02 guhkupg;g[

03=both

03= ,uz;Lk;

Where did the work take place? ,e;j ntiy v’;F eilbgw;wJ> Was that provision / development of new facility / service or maintenance activity? mJ g[jpa trjpfs;-nritfis nkk;gLj;Jtjw;fhdjh-my;yJ guhkupg;g[ eltof;ifah> 01 = Yes, new facility / service developed; 01=Mk;. g[jpa trjpfs;-nritfs; nkk;gLj;jg;gl;lJ 02 = Yes, maintenance activity taken place; 02=Mk;. guhkupg;g[ eltof;iffs; bray;gLj;jg;gl;ld 03 = Both - new facility / service developed & maintenance activity taken place 03=Mk;. ,uz;Lk; g[jpa trjpfs;-nritfis nkk;gLj;j kw;Wk; guhkupg;g[ eltof;iffs; Street-Neighborhood ID

gzp nkw;bfhs;sg;gl;l bjU? mUfhikapy; cs;s miahsgzp nkw;bfhs;sg;gl;l bjU? mUfhikapy; cs;s miahsgzp nkw;bfhs;sg;gl;l bjU? mUfhikapy; cs;s miahsgzp nkw;bfhs;sg;gl;l bjU? mUfhikapy; cs;s miahs vz;vz;vz;vz;

ST

RE

ET

ID

1

bjU milahs vz; 1

ST

RE

ET

ID

2

bjU milahs vz; 2

S

TR

EE

T I

D3

bjU milahs vz; 3

S

TR

EE

T I

D4

bjU milahs vz; 4

S

TR

EE

T I

D5

bjU milahs vz; 5

S

TR

EE

T I

D6

bjU milahs vz; 6

S

TR

EE

T I

D7

bjU milahs vz; 7

10. Housing-[Subsidised / Free

house construction or

improvement/ maintenance,

slum upgradation]

tPl;L trjp ? (khdpak; tH’;FtJ-,ytrkhf tPL fl;oj; jUtJ my;yJ trjpfis nkk;gLj;JtJ . Foirfisj; juk; cau;j;Jjy; nghd;wd)

11. Irrigation facilities / Public

Irrigation Facilities

(Construction / Maintenance

/ Improvement)

ghrd trjpfs;-bghJ ePu;g;ghrd trjpfs; (fl;Lkhdk;-guhkupg;g[-nkk;gLj;Jjy;)

12. Water harvesting

ePu; tsj;ij nkk;gLj;Jjy;

13. canals (Cleaning /

construction / improvement)

tha;f;fhy;fs; (Rj;jg;gLj;jy; -fl;Lkhdk;- nkk;gLj;jy;)

14. Electrification/Electric

supply

kpd; ,izg;g[f;fs; tH’;FtJ - kpd; tpdpnahfk;

15. Street Light

bjU tpsf;F


Details of the previous two gram sabhas held in the village

Kd;djhf fpuhkj;jpy; Kd;djhf fpuhkj;jpy; Kd;djhf fpuhkj;jpy; Kd;djhf fpuhkj;jpy; eilbgw;w eilbgw;w eilbgw;w eilbgw;w ,uz;L fpuhk rghf;fspd; tptu’;fs;,uz;L fpuhk rghf;fspd; tptu’;fs;,uz;L fpuhk rghf;fspd; tptu’;fs;,uz;L fpuhk rghf;fspd; tptu’;fs; Q.

no Details tptu’;fstptu’;fstptu’;fstptu’;fs; ; ; ;

Last Gram

sabha

filrp fpuhk rig

Previous

Gram sabha

Ke;ija fpuhk rig

467. When was the meeting held?

Tl;lk; vg;nghJ eilbgw;wJ> Year YYYY

tUlk; ???????

Month

khjk;

468. What time did the meeting begin?

Tl;lk;; ve;j neuj;jpy; bjhl';fpaJ> Time neuk;

469. Where did the meeting take place?

Tl;lk;; v’;nf ele;jJ> Under a tree kuj;joapy;

01 01

In a School gs;spapy;

02 02

In the Panchayat Office g”;rhaj;J mYtyfj;jpy;

03 03

In the Temple nfhapypy;

04 04

President’s house jiytu; tPl;oy;

05 05

SHG’S building Ra cjtpf; FG fl;olj;jpy;

06 06

VAO Office fpuhk epu;thf mYtyu; mYtyfj;jpy;

07 07

Other place [Specify] ________


08 08

470. Duration of meeting (minutes)

Tl;lk; vt;tst[ neuk; eilbgw;wJ (epkpl’;fs;) 471. How long in advance of the meeting was it announced to the public? (DAYS)

Tl;lk; elg;gjw;F . vj;jid ehl;fSf;F Kd;djhf bghJkf;fSf;F mwptpf;fg;gl;lJ> (ehl;fs;)

472. How was it announced to the public?

(code all applicable)

mJ bghJkf;fSf;F vg;go mwptpf;fg;gl;lJ> (bghUe;Jtd midj;ija[k; Fwpf;ft[k;)

Village / ward notice board

fpuhkk; - thu;L mwptpg;g[g; gyif 01 01

Public announcement (megaphone)

bghJ mwptpg;g[ (bkfh`nghd;) 02 02

Beating drums / tom tom

jz;nlhuh-lhk; lhk; 03 03

Pamphlet

gpuRuk; 04 04

Newspaper/magazine

bra;jpjhs; - gj;jpupiffs;; 05 05

Radio/TV

thbdhyp - bjhiyf;fhl;rp 06 06

Govt. official/GP secretary (clerk)

muR mYtyu; - fpuhk g”;rhaj;J brayhsu; (vGj;ju;)

07 07

Panchayat President/ Vice President

/ Ward member

g”;rhaj;J jiytu; - Jizj; jiytu; - thu;L cWg;gpdu;

08 08

Party worker

murpay; fl;rpf;fhf ntiy bra;gtu;fs; 09 09

Other community leader

kw;w rKjha jiytu;fs; 10 10

NGO / Community Organization

muRrhuh bjhz;L epWtd’;fs;-rKjha epWtd’;fs;

11 11

Other (Specify)

kw;wit (Fwpg;gpLf) 12 12


Q.


Last Gram

sabha

filrp fpuhk rig

Previous

Gram sabha

Ke;ija fpuhk rig

473. Who chaired the meeting?

Tl;lj;jpw;F ahu; jiyik jh’;fpdhu;fs;> GP President fpuhk g”;rhaj;J jiytu; 01 01

President's spouse jiytupd; Jiztu;

02 02

Other member of President's family jiytupd; FLk;gj;jpYs;s kw;w cWg;gpdu;

03 03

GP Clerk fpuhk g”;rhaj;J vGj;ju; 04 04

GP Vice President fpuhk g”;rhaj;J Jizj;jiytu;

05 05

Other GP member kw;w fpuhk g”;rhaj;J cWg;gpdu;

06 06

Higher Panchayat Members (like

councilor, Union Chairman, etc) cau;epiy g”;rhaj;J cWg;gpdu;fs; (ft[d;rpyu;. xd;wpa jiytu;fs; nghd;wtu;fs;)

07 07

Higher panchayat Government official (Block or

District level official)

cau;epiy g”;rhaj;J murh’;f mYtyu;fs; (tl;lk; my;yJ khtl;l mstpy;)

08 08

Other influential person in the village fpuhkj;jpy; cs;s ,ju bry;thf;F cs;s kdpju;fs;

09 09

Others (Specify) kw;wit (Fwpg;gplt[k;)

10 10

474. Number of panchayat members attended

Tl;lj;jpw;F tUif je;j g”;rhaj;J cWg;gpdu;fspd; vz;zpf;if

475. Number of citizens attended

Tl;lj;jpw;F tUif je;j Fokf;fspd; vz;zpf;if

476. Number of those in attendance who were female

tUif je;jtu;fspy; bgz;fspd; vz;zpf;if

477. Number of those in attendance who were from SC

tUif je;jtu;fspy;; jhH;j;jg;gl;l rK:fj;jpdupd; vz;zpf;if

478. Number of those in attendance who were from a ST tUif je;jtu;fspy;; gH';Fo rK:fj;jpdupd; vz;zpf;if

479. Number of higher level government officials attending

tUif je;jtu;fspy; murh’;f caujpfhupfspd; vz;zpf;if

480. 3 MOST IMPORTANT

ISSUES DISCUSSED/

DECISIONS TAKEN *

3 Kf;fpa gpur;rpidfs; fye;jhnyhrpf;fg;gl;lJ-Kot[ vLf;fg;gl;lJ DECISION codes:

jPu;khd FwpaPL

01 = secret ballot0

02 = show of hands

03 = voice vote

04=convener decided

05=president decided

06=ward members decided

later

07=no vote

*discussed for the longest

time

01=,ufrpa thf;bfLg;g[ 02=iffis cau;j;Jjy; 03=Fuy; thf;bfLg;g[ 04=rig elj;Jgtu; Kot[ bra;jhu; 05=jiytu; Kot[ bra;jhu;; 06=thu;L cWg;gpdu;fs; gpd;du; jPu;khdpj;jdu; 07=thf;bfLg;g[ ,y;iy *mjpf neuk; fye;Jiuahodhh;fs;

Most

important

Issue

kpf Kf;fpakhd gpur;rpid

Issue [WRITE EXACTLY]

gpur;rpid ? (brhy ;tij mg ;gona vGJf)

Issue (code given below)

gpur;rpid (FwpaPL)

vote type

Xl;od; tif

Second most

important

Issue ,uz;lhtJ Kf;fpakhd gpur;rpid




gpur;rpid (FwpaPL)

vote type

Xl;od; tif

Third most

important

Issue K:d;whtJ Kf;fpakhd gpur;rpid




gpur;rpid (FwpaPL)

vote type

Xl;od; tif


Q.


Last Gram

sabha

filrp fpuhk rig

Previous

Gram sabha

Ke;ija fpuhk rig

481. Presentation or approval of budget? gl;b$l; rku;g;gzk; bra;ag;gl;ljh my;yJ xg;g[jy; mspf;fg;gl;ljh>

presentation only

rku;g;gzk; kl;Lk; 01 01

budget presented and approved

rku;g;gpf;fg;gl;L xg;g[jy; bgwg;gl;lJ 02 02

budget presented but not approved

gl;b$l; rku;g;gpf;fg;gl;lJ Mdhy; xg;g[jy;;; bgwtpy ;iiy

03 03

budget not presented

gl;b$l; rku;g;gpf;fg;gltpy;iy 04 04

482.

Approval of beneficiaries on the agenda?

m$d;lhtpy; ,lk; bgw;wpUe;j gadhsp fSf;F xg;g[jy; jug;gl;ljh>

yes, passed unchanged

khw;wkpy;yhky; xg;g[jy; bra;ag;gl;lJ 01 01

yes, passed after changes

Mk;. khw;w’;fSf;Fg; gpd;du; xg;g[jy; bra;ag;gl;lJ

02 02

yes, but not approved

Mk; . Mdhy; xg;g[jy; jug;gltpy;iy 03 03

no

,y;iy 04 04

483. Are the minutes publicly available?

[right now]

Tl;lj;jpd; epfH;r;rpf; Fwpg;ngLfs; bghJkf;fs; ghh;itf;F fpilf;fpwjh> (,g;nghJ Tl)

Yes Mk; 01 01

No ,y;iy

02 02

Gram Sabha – issues discussed code fpuhk rig ? fye;jhnyhrpj;j gpur;rpidfspd; FwpaPL

Options Codes

Road rhiy 01

Transport nghf;Ftuj;J 02

Health cly; eyk; 03

Education fy;tp 04

Irrigation water ghrdj;jpw;fhd jz;zPh 05

Drinking water Fo jz;zPu; 06

Other agriculture related tptrhak; bjhlu;ghd kw;w gpur;rpidfs; 07

Ceremonies / Festivals g{i$fs;-tpHhf;fs; 08

Disputes tpthj’;fs; 09

Sewage / Sanitation rhf;fil-Rfhjhuk; 10

Construction other than roads or irrigation rhiy kw;Wk; ghrdk; my;yhj fl;Lkhd gzp 11

Access to and use of lands of the panchayat g";rhaj;J epy';fis gad;gLj;JtJ gw;wp 12

Unemployment schemes ntiy ,y;yhjth;fSf;fhd jpl;l’;fs; 13

Civil Supplies (ration shops) Foikg; bghUl;fs; tH’;Fjy; (nu&d; filfs;)

14

Availability of credit fpilf;Fk; fld;fisg; gw;wp 15

Usage of common property bghJ brhj;ij cgnahfpg;gJ Fwpj;J 16

Street light bjUtpsf;F 17

Electricity supply kpd;rhu tpepnahfk; 18

Cremation ground RLfhL 19

Other (specify) kw;wit (Fwpg;gpLf) 20


Location and characteristics of schools within village or within walking distance of village fpuhkj;jpy;; cs;s my;yJ fpuhkj;jpypUe;J eilJ}uj;jpy; cs;s gs;spf;Tl’;fs; mike;Js;s ,lk; kw;Wk; gz;g[fs; RECORD AS SEPARATE SCHOOL, IF 2 DIFFERENT SYLLABI FOLLOWED IN A SINGLE SCHOOL (LIKE MATRICULATION & CBSE SYLLABUS) xnu gs;spapy; ,uz;L ntW ghl jpl;l’;fs; elj;jpdhy; jdpj;jdp gs;spahf gjpt[ bra;at[k; Fwpg;gplt[k; (bkl;upf;Fny&d;. rpgpv!;, ghlKiw)

SC

HO

OL

FA

CIL

TY

ID

gs;spapd; milahs vz;

NAME OF THE

SCHOOL

gs;spf;Tlj;jpd; gs;spf;Tlj;jpd; gs;spf;Tlj;jpd; gs;spf;Tlj;jpd; bgau;bgau;bgau;bgau;

GPS READING OF

SCHOOLS gs;spf;Tl’;fspd; $pgpv!; uPo’;

If outside

village:

give

distance

from

village

(km.) fpuhkj;jpw;F btspna vdpy;

fpuhkj;jpy; ,Ue;J vt;tst[ J}uk; (fpkP)

What

type of

school is

this?

,J ve;j tifahd gs;sp>

CODE FwpaPL

What was / is

the

educational

system

followed?

gpd;gw;wg;gLk; fy;tp Kiw[ vd;dthf ,Ue;jJ - cs;sJ> CODE FwpaPL

School

management

gs;sp nkyhd;ik

CODE FwpaPL

Year

established

YYYY

Jtf;fg;gl;l tUlk;

Primary Language of

instruction ( Spoken

language for teaching)

(Codes given

below)

fw;gpf;Fk; Kjd;ikahd bkhHp (ngRk; bkhHpapy; fw;gpj;jy;)

(FwpaPLfs; fPnH bfhLf;fg;gl;Ls;sd)

Language of

textbooks

(Codes give

below)

ghlg;

g[j;jf’;fspd; bkhHp (FwpaPLfs;

fPnH bfhLf;fg;gl;Ls;sd)

Do students

learn a

second

language

khztu;fs; ,uz;lhtJ bkhHp gapy; fpd;whuh>

Second Language Taught

fw;gpf;fg;gLk; ,uz;lhtJ bkhHp

What is the

second language

studied?

(Codes give

below)

,uz;lhtjhf vd;d bkhHp

fw;gpf;fg;gLfpwJ> (fPnH

Fwpg;gplt[k;)

What is the

time spent

studying that

language per

week? [IN

HOURS, TO

NEAREST

QUARTER

HOUR. thuj;jpw;F vj;jid kzp neuk; ,uz;lhtJ bkhHpia fw;gjw;F brytplg; gLfpwJ> (kzpapy;) Y

es M

k;

,y;iy →

→

→

→

49

6

Q.no 484. 485. 486. 487. 488. 489. 490. 491. 492. 493. 494. 495.

S1 N: 01 02

E:

S2 N: 01 02

E:

S3 N: 01 02

E:

S4 N: 01 02

E:

S5 N: 01 02

E:

S6 N: 01 02

E:


Type of School Code

Options Code

Pre – school Muk;gg; gs;sp 01

Primary School

only bjhlf;fg; gs;sp kl;Lk; 02

Primary with

Upper Primary

School

bjhlf;fg; gs;spa[k; eLepiyg; gs;spa[k; 03

Primary with

Upper primary

school and

secondary/higher

secondary school

bjhlf;fg; gs;sp.; eLepiyg; gs;sp. cau;; epiyg; gs;sp kw;Wk; nky; epiyg; gs;sp ,ize;jJ

04

Upper primary

school only eLepiyg; gs;sp kl;Lk; 05

Upper primary

school with

secondary/higher

secondary school

eL epiyg; gs;sp. cau; epiyg; gs;sp kw;Wk; nky; epiyg; gs;sp ,ize;jJ

06

Secondary/

Higher Secondary

school only

cau; epiyg; gs;sp - nky; epiyg; gs;sp kl;Lk;

07

College fy;Y}hp 08

Industrial

Training bjhHpw; gapw;rp

09

Vocational

Training ifj;bjhHpw; gapw;rp

10

Others (Specify) kw;wit (Fwpg;gplt[k; 11

Education – standard Code

Options Code

Pre KG ghy;tho 01

Kindergarten (LKG/ UKG)

kHiyau; gs;sp 02

1st standard 1Mk; tFg;g[ 03

2nd

standard 2Mk; tFg;g[ 04

3rd


4th


5th


6th


7th


8th


9th


10th

standard / SSLC

10Mk; tFg;g[ - v!;v!;vy;rp 12

11th

standard / Junior college

11Mk; tFg;g[- $Pdpau; fhny$; 13

12th

std /HSC/ Junior college

12Mk; tFg;g[-v!;v!;vy;rp-$Pdpau; fhny$;

14

School management type Code

Options Code

Department of education

fy;tpj; Jiw 01

Tribal/social welfare dept

gH’;Foapdu; - rK:f eythH;j;Jiw 02

Local body school

cs;S:u; epu;thf gs;sp 03

Private aided

muR cjtp bgWk; jdpahu; gs;sp 04

Private unaided school

muR cjtp bgwhj jdpahh;gs;sp 05

Other recognized school

kw;w m’;fPfupf;fg;gl;l gs;spfs; 06

Unrecognized schools – religious

m’;fPfupf;fg;glhj gs;spfs; ? kjk; rhu;e;jit

07

Other Unrecognized schools

kw;w m’;fPfupf;fhj gs;spfs; 08

Others kw;wit 09

Language code

Options Code

Tamil jkpH; 01

English M’;fpyk; 02

Hindi ,e;jp 03

Telugu bjY’;F 04

Kannada fd;dlk; 05

Malayalam kiyahsk; 06

Urdu cUJ 07

Others (specify)

____________

kw;wit (Fwpg;gplt[k;) 08

Education system codes

Code

State board

khepyf; fy;tp thupak; 01

Matriculation

bkl;upFny&d; 02

Central board (CBSE)

kj;jpaf; fy;tp thupak; (rpgpv!;<)

03

Anglo Indian (AISC)

M';fpnyh ,e;jpad; 04

Others (Specify)

_______________

kw;wit (Fwpg;gplt[k;) 05


Schools: basic info cont. gs;spf;Tl’;fs; ? mog;gilj; jfty;fs; ? bjhlh;r;rpgs;spf;Tl’;fs; ? mog;gilj; jfty;fs; ? bjhlh;r;rpgs;spf;Tl’;fs; ? mog;gilj; jfty;fs; ? bjhlh;r;rpgs;spf;Tl’;fs; ? mog;gilj; jfty;fs; ? bjhlh;r;rp S

CH

OO

L F

AC

ILT

Y ID

gs;spf;Tl trjp milahs vz;

Length of typical

school day (exclude

extra classes,

extracurriculars, etc.)

rhjhuz ehspy; gs;spf;Tlj;jpd; ntiy

neuk; (rpwg;g[ tFg;g[f;fis nru;f;f ntz;lhk;)

Specify no. of Hours

kzp neu’;fspd; vz;zpf;if

Time Check

In the past 30 days

the school was

supposed to be

open, how many

days was it open?

fle;j 30 ehl;fspy; gs;sp

jpwe;jpUf;fg;gl ntz;oa ehl;fspy; vj;jid ehl;fs; gs;spf;Tlk; jpwe;jpUe;jJ>

Are school uniforms

required?

gs;spf;Tlj;jpw;F rPUil mky;

bra;ag;gl;Ls;sjh>

Do any students

not possess

textbooks used

for ONE or

MORE of their

classes?

khztu;fs; ahuhtJ ghlg; g[j;jf’;fs;

,y;yhky; xd;W my;yJ mjw;F nkw;gl;l

tFg;g[fSf;F tUfpwhu;fsh>

If yes, what percent of

students do not have

access to needed

textbooks?

Mk; vdpy; vj;jid rjtPj khztu;fs; njitahd

ghlg;g[j;jf’;fs; itj;jpUg;gjpy;iy>

From what source(s) do most students in this school obtain textbooks?

,e;j gs;spf;Tlj;jpYs;;s bgUk;ghyhd khztu;fs; v’;fpUe;J g[j;jf’;fs; th’;Ffpwhu;fs;>

borrow from school gs;spf;Tlj;jpy; ,uty; 01

given free of charge from school

gs;spf;Tlj;jpy; fl;lzkpd;wp ,ytrkhf jug;gLfpwJ

02

purchased from school

gs;spf;Tlj;jpy; th’;fg;gLfpwJ 03

purchased from other source

gpw ,l’;fspy; th’;fg;gLfpwJ 04

photocopy

efy; vLf;fg;gLfpwJ 05

used sibling's or other already owned

rnfhju rnfhjupfs; my;yJ Vw;fdnt brhe;jkhf itj;jpUe;jth;fsplkpUe;J

06

7 = other (Specify)

kw;wit Fwpg;gplt[k;) 07

Time

begun

Jt’;Fk; neuk;

Time

ended

Koa[k; neuk;

AM

fhiy PM

khiy Yes Mk;

No ,y;iy

Yes Mk;

No ,y;iy �� 503

Source 1

(most common)

Mjhuk; 1 (kpft[k; bghJthd)

Source 2

Mjhuk; 2 Source 3

Mjhuk; 3

Q.no 496. 497. 498. 499. 500. 501. 502. 503.

S1 01 02 01 02

S2 01 02 01 02

S3 01 02 01 02

S4 01 02 01 02

S5 01 02 01 02

S6 01 02 01 02


List all fees that students are required to pay (e. g. school fee, term fee, admission fee, ID card fee) khztu;fs; fl;l ntz;oa vy;yh fl;lz’;fisa[k; gl;oayplt[k;/ (ck;/ gs;spf;Tl fl;lzk; fhykhztu;fs; fl;l ntz;oa vy;yh fl;lz’;fisa[k; gl;oayplt[k;/ (ck;/ gs;spf;Tl fl;lzk; fhykhztu;fs; fl;l ntz;oa vy;yh fl;lz’;fisa[k; gl;oayplt[k;/ (ck;/ gs;spf;Tl fl;lzk; fhykhztu;fs; fl;l ntz;oa vy;yh fl;lz’;fisa[k; gl;oayplt[k;/ (ck;/ gs;spf;Tl fl;lzk; fhytiuf;fhdtiuf;fhdtiuf;fhdtiuf;fhd fl;lzk;. mDkjpf; flfl;lzk;. mDkjpf; flfl;lzk;. mDkjpf; flfl;lzk;. mDkjpf; fl;lzk;. milahs ml;il fl;lzk; );lzk;. milahs ml;il fl;lzk; );lzk;. milahs ml;il fl;lzk; );lzk;. milahs ml;il fl;lzk; ) SCHOOL – 1 NAME____ ___ FACILITY ID:

gs;sp ? 1 bgau; gs;spf;Tl trjp milahs vz; : Classes

tFg;g[f;fs;

Tution Fees

fy;tp fl;lz’;fs; Uniforms

rPUilfs; Books & Stationary

g[j;jf’;fs; kw;Wk; vGJ bghUl;fs; Other Small Fees

kw;w rpW fl;lz’;fs;

Others (Specify)


Others (Specify)


amoun

t

(Rs.)

bjhif (U:)

NOTE : IF “0”

→→→→

506 Fwpg;g[ ?;

“0” vdpy;;

→→→→

506

How often paid?

vt;tst[ mof;fo fl;lg;gL

fpwJ>

amount

(Rs.)

bjhif (U:)

NOTE : IF “0”

→→→→508 Fwpg;g[ :

“0” vdpy;

→→→→508508508508

How often paid?


fpwJ>

amount

(Rs.)

bjhif (U:)

NOTE : IF “0”

→ → → → 510

Fwpg;g[ : “0” vdpy;

→ → → → 510

How often paid?


fpwJ>

amount

(Rs.)

bjhif (U:)

NOTE : IF “0”

→ → → → 512

Fwpg;g[ : “0” vdpy;

→ → → → 512

How often paid?


fpwJ>

amount

(Rs.)

bjhif (U:)

NOTE : IF “0”

→ → → → 514 Fwpg;g[ :

“0” vdpy;

→ → → → 514

how often paid?


fpwJ>

amount

(Rs.)

bjhif (U:) NOTE : IF “0” SKIP TO NEXT

STD Fwpg;g[ :

“0” vdpy; mLj;j tFg;gpw;F bry;yt[k;

how often paid?


fpwJ> Numbe

r of times vj;jid jlit fs ;

Per week – 1,

Per month – 2,

In a Year – 3 thuk;?1 khjk;?2 tUlk;?3

Number of

times vj;jid jlit fs ;

Per week – 1,

Per month – 2,

In a Year – 3

thuk;?1 khjk;?2 tUlk;?3

Number of times vj;jid jlit fs ;

Per week – 1,

Per month – 2,

In a Year – 3



Per week – 1,

Per month – 2,

In a Year – 3


Number of


Per week – 1,

Per month – 2,

In a Year - 3


Number of times vj;jid jlit fs ;;

Per week – 1,

Per month – 2,

In a Year – 3


Q.no 504. 505. 506. 507. 508. 509. 510. 511. 512. 513. 514. 515.

1st Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

2nd

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

3rd

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

4th

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

5th

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

6th

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

7th

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

8th

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

9th

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

10th

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03


SCHOOL – 2 NAME____ ___ FACILITY ID:

gs;sp ? 2 bgau; gs;spf;Tl trjp milahs vz; :

Classes

tFg;g[f;fs;

Tution Fees





Others (Specify)


Others (Specify)


amount

(Rs.)

bjhif (U:)

if 00

��518

How often paid?


fpwJ>

amount

(Rs.)

bjhif (U:)

if 00

��555520202020

How often paid?


fpwJ>

amount

(Rs.)

bjhif (U:) ;

if 00

��522

How often paid?


fpwJ>

amount

(Rs.)

bjhif (U:)

if 00

��555524242424

How often paid?


fpwJ>

amount

(Rs.)

bjhif (U:)

if 00

��555526262626

how often paid?


fpwJ>

amount

(Rs.)


STD Fwpg;g[ :


how often paid?


fpwJ> Numbe


Per week – 1,

Per month – 2,


Number of


Per week – 1,

Per month – 2,

In a Year – 3



Per week – 1,

Per month – 2,

In a Year – 3



Per week – 1,

Per month – 2,

In a Year – 3


Number of


Per week – 1,

Per month – 2,

In a Year - 3



Per week – 1,

Per month – 2,

In a Year – 3


Q.no 516. 517. 518. 519. 520. 521. 522. 523. 524. 525. 526. 527.

1st Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

2nd

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

3rd

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

4th

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

5th

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

6th

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

7th

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

8th

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

9th

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

10th

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03




tFg;g[f;fs;

Tution Fees





Others (Specify)


Others (Specify)


amount

(Rs.)

bjhif (U:)

if 00

��530

How often paid?


fpwJ>

amount

(Rs.)

bjhif (U:)

if 00

��555533332222

How often paid?


fpwJ>

amount

(Rs.)

bjhif (U:) ;

if 00

��534

How often paid?


fpwJ>

amount

(Rs.)

bjhif (U:)

if 00

��555533336666

How often paid?


fpwJ>

amount

(Rs.)

bjhif (U:)

if 00

��555533338888

how often paid?


fpwJ>

amount

(Rs.)


STD Fwpg;g[ :


how often paid?


fpwJ> Numbe


Per week – 1,

Per month – 2,


Number of


Per week – 1,

Per month – 2,

In a Year – 3



Per week – 1,

Per month – 2,

In a Year – 3



Per week – 1,

Per month – 2,

In a Year – 3


Number of


Per week – 1,

Per month – 2,

In a Year - 3



Per week – 1,

Per month – 2,

In a Year – 3


Q.no 528. 529. 530. 531. 532. 533. 534. 535. 536. 537. 538. 539.

1st Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

2nd

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

3rd

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

4th

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

5th

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

6th

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

7th

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

8th

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

9th

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

10th

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03




Classes

tFg;g[f;fs;

Tution Fees





Others (Specify)


Others (Specify)


amount

(Rs.)

bjhif (U:)

if 00

��542

How often paid?


fpwJ>

amount

(Rs.)

bjhif (U:)

if 00

��555544444444

How often paid?


fpwJ>

amount

(Rs.)

bjhif (U:) ;

if 00

��546

How often paid?


fpwJ>

amount

(Rs.)

bjhif (U:)

if 00

��555548484848

How often paid?


fpwJ>

amount

(Rs.)

bjhif (U:)

if 00

��555550505050

how often paid?


fpwJ>

amount

(Rs.)


STD Fwpg;g[ :


how often paid?


fpwJ> Numbe


Per week – 1,

Per month – 2,


Number of


Per week – 1,

Per month – 2,

In a Year – 3



Per week – 1,

Per month – 2,

In a Year – 3



Per week – 1,

Per month – 2,

In a Year – 3


Number of


Per week – 1,

Per month – 2,

In a Year - 3



Per week – 1,

Per month – 2,

In a Year – 3


Q.no 540. 541. 542. 543. 544. 545. 546. 547. 548. 549. 550. 551.

1st Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

2nd

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

3rd

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

4th

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

5th

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

6th

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

7th

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

8th

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

9th

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

10th

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03




tFg;g[f;fs;

Tution Fees





Others (Specify)


Others (Specify)


amount

(Rs.)

bjhif (U:)

if 00

��554

How often paid?


fpwJ>

amount

(Rs.)

bjhif (U:)

if 00

��555556565656

How often paid?


fpwJ>

amount

(Rs.)

bjhif (U:) ;

if 00

��558

How often paid?


fpwJ>

amount

(Rs.)

bjhif (U:)

if 00

��555560606060

How often paid?


fpwJ>

amount

(Rs.)

bjhif (U:)

if 00

��555562626262

how often paid?


fpwJ>

amount

(Rs.)


STD Fwpg;g[ :


how often paid?


fpwJ> Numbe


Per week – 1,

Per month – 2,


Number of


Per week – 1,

Per month – 2,

In a Year – 3



Per week – 1,

Per month – 2,

In a Year – 3



Per week – 1,

Per month – 2,

In a Year – 3


Number of


Per week – 1,

Per month – 2,

In a Year - 3



Per week – 1,

Per month – 2,

In a Year – 3


Q.no 552. 553. 554. 555. 556. 557. 558. 559. 560. 561. 562. 563.

1st Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

2nd

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

3rd

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

4th

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

5th

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

6th

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

7th

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

8th

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

9th

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

10th

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03




Classes

tFg;g[f;fs;

Tution Fees





Others (Specify)


Others (Specify)


amount

(Rs.)

bjhif (U:)

If 00

��566

How often paid?


fpwJ>

amount

(Rs.)

bjhif (U:)

If 00

��555568686868

How often paid?


fpwJ>

amount

(Rs.)

bjhif (U:) ;

if 00

��570

How often paid?


fpwJ>

amount

(Rs.)

bjhif (U:)

if 00

��555572727272

How often paid?


fpwJ>

amount

(Rs.)

bjhif (U:)

if 00

��555574747474

how often paid?


fpwJ>

amount

(Rs.)


STD Fwpg;g[ :


how often paid?


fpwJ> Numbe


Per week – 1,

Per month – 2,


Number of


Per week – 1,

Per month – 2,

In a Year – 3



Per week – 1,

Per month – 2,

In a Year – 3



Per week – 1,

Per month – 2,

In a Year – 3


Number of


Per week – 1,

Per month – 2,

In a Year - 3



Per week – 1,

Per month – 2,

In a Year – 3


Q.no 564. 565. 566. 567. 568. 569. 570. 571. 572. 573. 574. 575.

1st Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

2nd

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

3rd

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

4th

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

5th

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

6th

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

7th

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

8th

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

9th

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03

10th

Std 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03 01 02 03


Schools: Enrollment and teacher details

gs;spf;Tl’;fs; ? khztu; nrh;f;if kw;Wk; Mrpupau; gw;wpa tptu’;fs;gs;spf;Tl’;fs; ? khztu; nrh;f;if kw;Wk; Mrpupau; gw;wpa tptu’;fs;gs;spf;Tl’;fs; ? khztu; nrh;f;if kw;Wk; Mrpupau; gw;wpa tptu’;fs;gs;spf;Tl’;fs; ? khztu; nrh;f;if kw;Wk; Mrpupau; gw;wpa tptu’;fs; School

number

gs;spf; Tl vz;

Details of Enrolled Students gs;spapy; nru;e;J gof;Fk; khztu;fspd;;; tptu’;fs;

Number of teachers Mrpupau;fspd; vz;zpf;if Headmaster jiyik Mrpupah;

number of

male

students

(2008 –

2009)

Mz;;Mz;;Mz;;Mz;; khztu;fspd;

vz;zpf;if

(2008 –

2009)

number

of

female

students

(2008 –

2009)

bgz;;;bgz;;;bgz;;;bgz;;; khztpfspd;

vz;zpf;if

(2008 –

2009)

what percent of

enrolled

students are in

school on a

typical day?

(2008 – 2009)

gs;spapy; nru;e;J gof;Fk;

khztu;fspy; vj;jid rjtPjk; ngu; xU ruhrup ehspy; gs;spf;F

tUfpwhu;fs;> (2008 – 2009)

enrollmen

t for

previous

school

year

(2007 –

2008)

Ke;ija Mz;oy; khztu; nru;f;if (2007 –

2008)

Sex ghypdk; Qualification

fy;tpj; jFjp Experience mDgtk; Sex;

Years in

position

gjtpapy; vj;jid tUl’;fs; ,Uf;fpwhu;>

Qualification

fy;tpj; jFjp high school

diploma cau;epiy fy;tp- gl;lag; gog;g[

01

graduate

degree

,sepiy gl;ljhup

02

post-

graduate

degree KJepiy gl;ljhup

03

Name, if

resident of

village

fpuhk thrp vdpy; bgau; vd;d>

HH

ID

FLk;g milahs vz;

Memb

er ID cWg;gpdu; milahs vz;

M

Mz; F

bgz; Undergr

aduate

(high

school

diploma

, etc.)

cau; epiy fy;tp- gl;lag; gog;g[

graduat

e degree

(B.A.,

B.SC.,

B.COM

)

,s epiy gl;ljhupfs;

post-

graduate

degree

(M.A.,

M.SC.,

M.COM)

KJ epiy gl;ljhupfs;

have

taught 2

years or

less

2 tUlk; my;yJ mjw;F Fiwthf gapw;Wtpj; Js;stu;f

s;

have

taught

between 2

and 10

years

2 ?? 10 tUl’;fs; gapw;Wtpj; Js;stu;f

s;

have

taught 10

years or

more

10 ?

tUl’;fSf;F nky; gapw;W tpj;Js;stu;fs;

M

Mz;

F

bgz;

Q.no 576. 577. 578. 579. 580. 581. 582. 583. 584. 585. 586. 587. 588. 589. 590. 591. 592.

S1

01 02

S2

01 02

S3

01 02

S4

01 02

S5

01 02

S6

01 02


Schools: Facilities and programs gs;spf;Tl’;fs; ? trjpfs; kw;Wk; jpl;l’;fs;gs;spf;Tl’;fs; ? trjpfs; kw;Wk; jpl;l’;fs;gs;spf;Tl’;fs; ? trjpfs; kw;Wk; jpl;l’;fs;gs;spf;Tl’;fs; ? trjpfs; kw;Wk; jpl;l’;fs; SL Source of

drinking

water

CODE

FoePUf; fhd Mjhuk; FwpaPL

Does the

school

have

electricity?

gs;spf; Tlj;jp;y; kpd; trjp ,Uf;fpw jh>

Does your

school have

a library?

c’;fs; gs;spapy; xU E}yfk; cs;sjh>

If yes,

approxi

mately

how

many

books

does it

have? \

Mk; vdpy; . njhuha khf mjpy; vj;jid g[j;jf’;fs; cs;sd>

Does the

school provide

midday meals?

gs;spapy; kjpa czt[ tH’;fg; gLfpwjh> 01 = yes, to all

students

Mk;/ vy;nyhUf;Fk; 02 = yes, only to

some students

Mk;. rpy khztu; fSf;F kl;Lk; 03 = no

,y;iy

Does the

school have a

parents'

committee or

Parent

Teacher’s

Association?

gs;spapy; bgw;nwhu; mikg;g[ my;yJ bgw;nwhh; Mrpupau; fHfk; cs;sjh>

If yes, how

many times

has it met in

the previous

year?

Mk; vdpy;. mJ fle;j tUlj;jpy; vj;jid Kiw To cs;sJ> vz;zpf;if

How many [ . . .] does your school have?

c’;fs; gs;spapy; vj;jid /////// cs;sJ> Does the school have

[ . . .]? 1 = yes; 2 = no

[ . . .]gs;spapy; ,Uf;fpwjh> 1=Mk;. 2=,y;iy

Computers for

students use

khztu;fs; gad; gLj;j fk;g;a{l;lu;fs;

Functional Lavatories

fHpg;giwfs; Black

boards

fUk; gyif fs;

vz;zpf;if

NOs.

No. of

classrooms

for

teaching.

ghlk; elj;Jk; tFg;giwfspd; vz;zpf;if

NOs.

Laboratory

gupnrhjidf; Tlk;

playground /

sports field tpisahl;L ikjhdk

FURNITURE

FOR

TEACHERS

Mrpupau; fSf;fhd ehw;fhyp nkirfs;

connected

to the

internet

,d;lu;; bel; ,izg;g[ld; vj;jid cs;sd>

NOs.

not

connecte

d to the

internet

,d;lu; bel; ,izg;g[ ,y;;yhky; vj;jid cs;sd> NOs.

girls only

khztpfSf;F kl;Lk;

NOs.

Common

toilet

,UghyUf;fhd fHptiw NOs.

Ye

s Mk;

No ,y;iy

Yes Mk;

No ,y;iy

→ → → →

597597597597

Yes Mk;

No ,y;iy

→→→→

600600600600

Yes Mk;

No ,y;iy

Yes Mk;

No ,y;iy

Yes Mk;

No ,y;iy

Q.

no 593. 594. 595. 596. 597. 598. 599. 600. 601. 602. 603. 604. 605. 606. 607. 608.

S1 01 02 01 02

01 02

01 02 01 02 01 02

S2 01 02 01 02

01 02

01 02 01 02 01 02

S3 01 02 01 02

01 02

01 02 01 02 01 02

S4 01 02 01 02

01 02

01 02 01 02 01 02

S5 01 02 01 02

01 02

01 02 01 02 01 02

S6 01 02 01 02

01 02

01 02 01 02 01 02


Health Services: Visits by Outside Village Health workers Rfhjhu Rfhjhu Rfhjhu Rfhjhu nritfs;nritfs;nritfs;nritfs; ???? btsp fpuhkj;jpypUe;J ghh;itapLk; btsp fpuhkj;jpypUe;J ghh;itapLk; btsp fpuhkj;jpypUe;J ghh;itapLk; btsp fpuhkj;jpypUe;J ghh;itapLk; Rfhjhu Rfhjhu Rfhjhu Rfhjhu gzpahsu;fs;gzpahsu;fs;gzpahsu;fs;gzpahsu;fs;

Type of services

nritfspd; tif

Frequency of visits by (code)*

vt;tst[ fhy ,ilbtspapy; tprpl; bra;ag;gLfpwJ> (FwpaPL) * Do the visitor(s)

conduct this effort at

an existing medical

clinic/facility in the

village?

,e;j Rfhjhu gzpahsu;fs; c’;fs; Chpy; ,g;nghJs;s xU kUj;Jtkid- kUj;Jt trjpa[s;s ,lj;jpy; nrit bra;fpwhu;fsh>

If yes, where have

these efforts

conducted ?

Mk; vdpy;. v’;F ,Ue;J

eltof;if vLf;fg;gLfpwJ>

[write exactly]

Like Name, Type

of facility (e.g.,

anganwadi ,

Clinic, etc)

(rupahf vGjt[k;) bgau;. kUj;Jt nrit tH’;Fk; ,lj;jpd; tif (m’;fd;tho. kUe;jfk; ,ju)

MULTICODING

POSSIBLE

gy gjpy;fs; rhj;jpak;

Health

FACILITY

ID

(Copy

from

Village

Questionna

ire)

Rfhjhu trjpfs; milahs vz;

Doctors from govt. or other govt. officials

murh’;f lhf;lu;fs; my;yJ gpw murh’;f mYtyu;fs;

Doctors from NGO, university, religious

organization

bjhz;L epWtd’;fs;. gy;fiyf; fHf’;fs; kw;Wk; kj mikg;g[fspypUe;J tUk; lhf;lu;fs;

Other visiting medical personel/

paramedics/VHN/CHN tprpl; bra;a[k; gpw kUj;Jt mYtyu;fs;- kUj;Jt fsg;gzpahsu;fs;-tpvr;vd;-rpvr;vd;-gzpahsh;fs;

Number of times

Note: If “On call /

emergency” – write 1

and circle “4”

If “Never” – record “0”

and circle “5” in the

next column.

tprpl; bra;a[k; vz;zpf;iffs; Fwpg;g[ ? Tg;gpl;l neuj;jpy; mtruk; vdpy;. 1 vGjp 4?I tl;lkplt[k; ,y;iybadpy; 0?it gjpt[ bra;J 5?I tl;lkplt[k;

Per week – 1,

Per month – 2,

Per Year – 3

On call /

emergency – 4

Never – 5

thuk;?1 khjk;?2 tUlk;?3 mtruj;jpy;?4 xUbghGJk; ,y;iy?5

Number of times


emergency” – write 1 and

circle “4”


and circle “5” in the next

column. tprpl; bra;a[k; vz;zpf;iffs; Fwpg;g[ ? Tg;gpl;l neuj;jpy; mtruk; vdpy;. 1 vGjp 4?I Fwpg;gplt[k; ,y;iybadpy; 0?it gjpt[ bra;J 5?I tl;lkplt[k;

Per week – 1,

Per month – 2,

Per Year – 3

On call /

emergency – 4

Never – 5


Number of times



and circle “4”

If “Never” – record

“0” and circle “5” in

the next column.

tprpl; bra;a[k; vz;zpf;iffs; Fwpg;g[ ? Tg;gpl;l neuj;jpy; mtruk; vdpy;. 1 vGjp 4?I Fwpg;gplt[k; ,y;iybadpy; 0?it gjpt[ bra;J 5?I tl;lkplt[k;

Per week – 1,

Per month – 2,

Per Year – 3

On call /

emergency – 4

Never – 5


Yes Mk;

No ,y;iy ��NEXT

ROW

Q.no 609. 610. 611. 612. 613. 614.

Water

purification

jz;zPu; Rj;jfupg;g[

Chlorinate wells Fnshupd; fyf;fg;gLk; fpzWfs;

1 2 3 4 5

1 2 3 4 5

1 2 3 4 5

Malaria

eradication

knyupah xHpg;g[

Spraying

bjspj;jy;

1 2 3 4 5

1 2 3 4 5

1 2 3 4 5

Blood slides

,uj;j rhk;gps; !;iyLfs;

1 2 3 4 5

1 2 3 4 5

1 2 3 4 5

01

02

→ → → → Next

type

Quinine pills

Fapdh khj;jpiufs;

1 2 3 4 5

1 2 3 4 5

1 2 3 4 5

01

02

→ → → → Next

type

Other malaria eradication

efforts (specify):

kw;w knyupah XHpg;g[ Kiwfs;;;; (Fwpg;gpLf)

1 2 3 4 5

1 2 3 4 5

1 2 3 4 5

01

02

→ → → → Next

type

Blindness prevention & cure

fz;;; ghu;it ,Hg ;ig jLj ;jy ; kw ;Wk ; Fzg ;gLj ;Jjy ;

1 2 3 4 5

1 2 3 4 5

1 2 3 4 5

01

02

→ → → → Next

type


Type of services

nritfspd; tif




an existing medical


village?


If yes, where have

these efforts

conducted ?



[write exactly]

Like Name, Type

of facility (e.g.,

anganwadi ,

Clinic, etc)


MULTICODING

POSSIBLE


Health

FACILITY

ID

(Copy

from

Village

Questionna

ire)





organization




Number of times



and circle “4”



next column.


Per week – 1,

Per month – 2,

Per Year – 3

On call /

emergency – 4

Never – 5


Number of times



circle “4”




Per week – 1,

Per month – 2,

Per Year – 3

On call /

emergency – 4

Never – 5


Number of times



and circle “4”



the next column.


Per week – 1,

Per month – 2,

Per Year – 3

On call /

emergency – 4

Never – 5


Yes Mk;

No ,y;iy ��NEXT

ROW

Q.no 609. 610. 611. 612. 613. 614.

Immunization of children

FHe;ijfSf;F jLg;g{rp

1 2 3 4 5

1 2 3 4 5

1 2 3 4 5

01

02

→ → → → Next

type

Help for

pregnant

women

fh;gpzpg; bgz;fSf;fhd cjtpfs;

Iron & Vitamin pills

,Uk;g[r; rj;J & tpl;lkpd; khj;jpiufs;

1 2 3 4 5

1 2 3 4 5

1 2 3 4 5 01

02

→ → → → Next

type

Prenatal check-ups

gpurtj;jpw;F Ke;ija gupnrhjidfs;

1 2 3 4 5

1 2 3 4 5

1 2 3 4 5 01

02

→ → → → Next

type

Deliver babies

gpurtk; ghu;j;jy;

1 2 3 4 5

1 2 3 4 5

1 2 3 4 5 01

02

→ → → → Next

type

Other help for pregnant

women (specify):

fUt[w;w bgz;fSf;F kw;w cjtpfs; (Fwpg;gpLf)

1 2 3 4 5

1 2 3 4 5

1 2 3 4 5 01

02

→ → → → Next

type


Type of services

nritfspd; tif




an existing medical


village?


If yes, where have

these efforts

conducted ?



[write exactly]

Like Name, Type

of facility (e.g.,

anganwadi ,

Clinic, etc)


MULTICODING

POSSIBLE


Health

FACILITY

ID

(Copy

from

Village

Questionna

ire)





organization




Number of times



and circle “4”



next column.


Per week – 1,

Per month – 2,

Per Year – 3

On call /

emergency – 4

Never – 5


Number of times



circle “4”




Per week – 1,

Per month – 2,

Per Year – 3

On call /

emergency – 4

Never – 5


Number of times



and circle “4”



the next column.


Per week – 1,

Per month – 2,

Per Year – 3

On call /

emergency – 4

Never – 5


Yes Mk;

No ,y;iy ��NEXT

ROW

Q.no 609. 610. 611. 612. 613. 614.

Nutritional

supplements

Cl;lr;rj;J <L bra;a[k;; bghUl;fs;

For breast-feeding

women

ghY}l;Lk; jha; khu;fSf;F

1 2 3 4 5

1 2 3 4 5

1 2 3 4 5 01

02

→ → → → Next

type

For children

FHe;ijfSf;F

1 2 3 4 5

1 2 3 4 5

1 2 3 4 5 01

02

→ → → → Next

type

For everyone

vy;nyhUf;Fk;

1 2 3 4 5

1 2 3 4 5

1 2 3 4 5 01

02

→ → → → Next

type

General health education / advice bghJ Mnuhf;fpa fy;tp-mwpt[iu

1 2 3 4 5

1 2 3 4 5

1 2 3 4 5 01

02

→ → → → Next

type

Family planning education FLk;gf; fl;Lg;ghl;Lf; fy;tp

1 2 3 4 5

1 2 3 4 5

1 2 3 4 5 01

02

→ → → → Next

type

Condom distribution

Mqiw tpdpnahfk;

1 2 3 4 5

1 2 3 4 5

1 2 3 4 5 01 02

→ → → → Next


Type of services

nritfspd; tif




an existing medical


village?


If yes, where have

these efforts

conducted ?



[write exactly]

Like Name, Type

of facility (e.g.,

anganwadi ,

Clinic, etc)


MULTICODING

POSSIBLE


Health

FACILITY

ID

(Copy

from

Village

Questionna

ire)





organization




Number of times



and circle “4”



next column.


Per week – 1,

Per month – 2,

Per Year – 3

On call /

emergency – 4

Never – 5


Number of times



circle “4”




Per week – 1,

Per month – 2,

Per Year – 3

On call /

emergency – 4

Never – 5


Number of times



and circle “4”



the next column.


Per week – 1,

Per month – 2,

Per Year – 3

On call /

emergency – 4

Never – 5


Yes Mk;

No ,y;iy ��NEXT

ROW

Q.no 609. 610. 611. 612. 613. 614.

type Other (specify):

kw;wit (Fwpg;gpLf)

1 2 3 4 5

1 2 3 4 5

1 2 3 4 5 01

02

→ → → → Next

type

Other (specify):

kw;wit (Fwpg;gpLf)

1 2 3 4 5

1 2 3 4 5

1 2 3 4 5 01 02

→ 6→ 6→ 6→ 611115555


Types of health workers currently available in this village: ,e;j ,e;j ,e;j ,e;j fpuhkj;jpy; fpuhkj;jpy; fpuhkj;jpy; fpuhkj;jpy; jw;rkak; jw;rkak; jw;rkak; jw;rkak; fpilf;Fk; fpilf;Fk; fpilf;Fk; fpilf;Fk; Rfhjhu Rfhjhu Rfhjhu Rfhjhu gzpahsu;fsgzpahsu;fsgzpahsu;fsgzpahsu;fspd; tifpd; tifpd; tifpd; tif

Q. no Options code

615. Is there Trained dai available in this Village?

gapw;rp bgww jha; ,e;j fpuhkj;jpy; cs;shuh> Yes Mk; 01

No ,y;iy 02

616. Is there Trained male health worker available in this Village?

gapw;rp bgw;w Mz; Rfhjhu gzpahsu; ,e;j fpuhkj;jpy; cs;shuh> Yes Mk; 01

No ,y;iy 02

617. Is there Trained female health worker available in this Village?

gapw;rp bgw;w bgz; Rfhjhu gzpahsu; ,e;j fpuhkj;jpy; cs;shuh> Yes Mk; 01

No ,y;iy 02

NEAREST HEALTH CARE PROVIDERS OUTSIDE THE VILLAGE fpuhkj;jpw;F btspfpuhkj;jpw;F btspfpuhkj;jpw;F btspfpuhkj;jpw;F btspapy; mUfhikapapy; mUfhikapapy; mUfhikapapy; mUfhikapYs;s Rfhjhu guhkupg;g[ nriYs;s Rfhjhu guhkupg;g[ nriYs;s Rfhjhu guhkupg;g[ nriYs;s Rfhjhu guhkupg;g[ nrit t t t ika’;fs;ika’;fs;ika’;fs;ika’;fs; SNO INVESTIGATOR: REFER TO

FIRST PAGE OF VILLAGE

SCHEDULE AS CROSS CHECK

ngl;o vLg;gth; /; fpuhk ml;ltizapd; Kjy; gf;fj;ijg; rhpghh;g;gjw;F itj;Jf; bfhs;st[k;

Is there a [….] in

this village? IF

NO � NEXT

ROW

fpuhkj;jpy; xU

[….] cs;sjh> ,y;iy vdpy; mLj;j tupirf;Fr; bry;yt[k;

Year of

establishment

Jtf;fg;gl;l tUlk;

Number of patients

treated/ day

xU ehisf;F rpfpr;ir bgWk; nehahspfspd; vz;zpf;if

Open how many

days in a week?

xU thuj;jpy; vj;jid ehs; jpwe;jpUf;Fk;>

No. of hrs. per

day

xU ehisf;F vj;jid kzp neuk; jpwe;jpUf;Fk; >

Male doctors in place

Mz; kUj;Jth; ,Uf;fpwhuh> ,Ue;jhy; vj;jid Mz; kUj;Jtu;fs;>

Female Doctors in Place

bgz; kUj;Jth; ,Uf;fpwhuh> ,Ue;jhy; vj;jid bgz; kUj;Jtu;fs;>

Number of beds

available for

treatment and

delivery rpfpr;ir mspg;gjw;Fk; gpurtk; ghu;g;gjw;Fk; fpilf;Fk; bkhj;j gLf;iffspd; vz;zpf;if

Yes Mk;

No ,y;iy

Yes Mk;

No ,y;iy →→→→ 6 6 6 625252525

Number

vz;zpf;if Yes Mk;

No ,y;iy −−>6−−>6−−>6−−>627272727

Number

vz;zpf;if

Q.no 618. 619. 620. 621. 622. 623. 624. 625. 626. 627.

1 Government / Municipal Hospital

murh’;f - Kdprpgy; kUj;Jtkid 01 02

01 02

01 02

2 Govrnment Dispensary

muR kUe;jfk; 01 02

01 02

01 02

3 UHC / UHP / UFWC

a[b\r;rp - a[b\r;gp- a[v`;g;lgps;a[ rp

01 02

01 02

01 02

4 Community Health Centre (CHC) /

Rural Hospital / PHC

rKjha Rfhjhu ikak; (CHC) - fpuhk kUj;Jtkid / Muk;g Rfhjhu epiyak;-PHC

01 02

01 02

01 02


SNO INVESTIGATOR: REFER TO

FIRST PAGE OF VILLAGE

SCHEDULE AS CROSS CHECK

ngl;o vLg;gth; /; fpuhk ml;ltizapd; Kjy; gf;fj;ijg; rhpghh;g;gjw;F itj;Jf; bfhs;st[k;

Is there a [….] in

this village? IF

NO � NEXT

ROW

fpuhkj;jpy; xU

[….] cs;sjh> ,y;iy vdpy; mLj;j tupirf;Fr; bry;yt[k;

Year of

establishment

Jtf;fg;gl;l tUlk;

Number of patients

treated/ day

xU ehisf;F rpfpr;ir bgWk; nehahspfspd; vz;zpf;if

Open how many

days in a week?

xU thuj;jpy; vj;jid ehs; jpwe;jpUf;Fk;>

No. of hrs. per

day

xU ehisf;F vj;jid kzp neuk; jpwe;jpUf;Fk; >

Male doctors in place

Mz; kUj;Jth; ,Uf;fpwhuh> ,Ue;jhy; vj;jid Mz; kUj;Jtu;fs;>

Female Doctors in Place

bgz; kUj;Jth; ,Uf;fpwhuh> ,Ue;jhy; vj;jid bgz; kUj;Jtu;fs;>

Number of beds

available for

treatment and

delivery rpfpr;ir mspg;gjw;Fk; gpurtk; ghu;g;gjw;Fk; fpilf;Fk; bkhj;j gLf;iffspd; vz;zpf;if

Yes Mk;

No ,y;iy

Yes Mk;

No ,y;iy →→→→ 6 6 6 625252525

Number

vz;zpf;if Yes Mk;

No ,y;iy −−>6−−>6−−>6−−>627272727

Number

vz;zpf;if

5 Sub Centre

Jiz kUj;Jt ikak; 01 02

01 02

01 02

6 Public Sector health facility

bghJj;Jiw kUj;Jt trjpfs; 01 02

01 02

01 02

7 NGO or Trust Hospital / Clinic

bjhz;L epWtdk; my;yJ mwf;fl;lis kUj;Jtkid-fpspdpf;

01 02

01 02

01 02

8 Private Hospital / Nursing Home /

Clinic

jdpahh; kUj;Jtkid-eu;rp’; n\hk;- fpspdpf;

01 02

01 02

01 02

9 Private Medical shop / Pharmacy

jdpahh; kUe;J fil - kUe;J tH’;Fkplk;

01 02

01 02

01 02


Health Care Facilities INSIDE the Village: Detailed Information

fpuhkj;jpfpuhkj;jpfpuhkj;jpfpuhkj;jpw;F cs;nsw;F cs;nsw;F cs;nsw;F cs;ns mike;Js;s mike;Js;s mike;Js;s mike;Js;s Rfhjhu Rfhjhu Rfhjhu Rfhjhu nrit nrit nrit nrit ikaikaikaika’;fs;’;fs;’;fs;’;fs; ? tp? tp? tp? tpupthd jfty;fs;upthd jfty;fs;upthd jfty;fs;upthd jfty;fs; H

EA

LT

H F

AC

ILIT

Y I

D


LIST ALL

FACILITIES

WITHIN THE

VILLAGE LIMITS –

NAMES fpuhk vy;iyf;Fs; fpilf;Fk; vy;yh nrit fisa[k; gl;oayplt[k;

GPS

Reading $p gp v!; fzf;

bfLg;g[

What

year was

the

facility

establishe

d?

YYYY

,e;j ikak; ve;j Mz;L Jtf;fg; gl;lJ>

What type

of health

facility is

this?

,J vd;d tifahd trjp

(Use Codes

given

below) (fPnH bfhLf;fg;gl;Ls;s FwpaPLfis gad;gLj;Jf)

FACILITIES PROVIDED (READ OUT)

Multicoding Possible

tH’;fg;gLk; kUj;Jt trjpfs; (gof;ft[k;) gy gjpy;fs; rhj;jpak;

IF THIS FACILITY OFFERS FAMILY

PLANNING / BIRTH CONTROL

,e;j kUj;Jt kidapy; FLk;g fl;Lg;ghL - FHe;ij gpwg;g[ fl;Lg;ghL

trjpfs; tH’;fg;gLfpd;wdth>

IF THIS FACILITY OFFERS

IMMUNIZATIONS,

,e;j kUj;Jt ikaj;jpy; jLg;g{rpfs;

nghlg;gLfpd;wdth> Which types?

(RANK in order of frequency of

distribution]

ve;j tiffspy;> (kpf mof;fo tH’;fg;gLtjd; mog;gilapy; nu’;f;

gl;oayplt[k;) (Use Codes given below)


Are the following

Immunizations offered?

fPH; tUk; jLg;g{rpfs; nghlg;gLfpd;wd>

Prenatal

check-

ups

Kd; ngU fhy gupnrhjid

Delivery

gpurtk; Family

Planning /

Birth control

FLk;gf; fl;Lg;ghL - FHe;ij gpwg;g[

fl;Lg;ghL

Immuni

za ions jLg;g{rpfs;

First

Aid

KjYjtp

Nutrition

al

Supplim

ents

Cl;lr; rj;J tH’;fy;

Medicine

s

kUe;J

General

Health

Education /

Advice

bghJ cly; eyf; fy;tp - mwpt[iu

Rank 1

nu’;f;; 1

Code FwpaPL

Rank 2

nu’;f;; 2

Code FwpaPL

Rank 3

nu’;f;; 3

Code

FwpaPL

Polio

nghypnah

Meas

les

jl;lk;ik

BCG

gprp$p DPT

ogpo

Q.no 628. 629. 630. 631. 632. 633. 634.

H1 N 01 02 03 04 05 06 07 08

01 02 03 04

E

H2 N 01 02 03 04 05 06 07 08

01 02 03 04

E

H3 N 01 02 03 04 05 06 07 08

01 02 03 04

E

H4 N 01 02 03 04 05 06 07 08

01 02 03 04

E

H5 N

01 02 03 04 05 06 07 08

01 02 03 04 E


HE

AL

TH

FA

CIL

ITY

ID


LIST ALL

FACILITIES

WITHIN THE

VILLAGE LIMITS –

NAMES fpuhk vy;iyf;Fs; fpilf;Fk; vy;yh nrit fisa[k; gl;oayplt[k;

GPS

Reading $p gp v!; fzf;

bfLg;g[

What

year was

the

facility

establishe

d?

YYYY

,e;j ikak; ve;j Mz;L Jtf;fg; gl;lJ>

What type

of health

facility is

this?

,J vd;d tifahd trjp

(Use Codes

given

below) (fPnH bfhLf;fg;gl;Ls;s FwpaPLfis gad;gLj;Jf)

FACILITIES PROVIDED (READ OUT)

Multicoding Possible

tH’;fg;gLk; kUj;Jt trjpfs; (gof;ft[k;) gy gjpy;fs; rhj;jpak;

IF THIS FACILITY OFFERS FAMILY

PLANNING / BIRTH CONTROL

,e;j kUj;Jt kidapy; FLk;g fl;Lg;ghL - FHe;ij gpwg;g[ fl;Lg;ghL

trjpfs; tH’;fg;gLfpd;wdth>

IF THIS FACILITY OFFERS

IMMUNIZATIONS,

,e;j kUj;Jt ikaj;jpy; jLg;g{rpfs;

nghlg;gLfpd;wdth> Which types?

(RANK in order of frequency of

distribution]

ve;j tiffspy;> (kpf mof;fo tH’;fg;gLtjd; mog;gilapy; nu’;f;

gl;oayplt[k;) (Use Codes given below)


Are the following

Immunizations offered?

fPH; tUk; jLg;g{rpfs; nghlg;gLfpd;wd>

Prenatal

check-

ups

Kd; ngU fhy gupnrhjid

Delivery

gpurtk; Family

Planning /

Birth control

FLk;gf; fl;Lg;ghL - FHe;ij gpwg;g[

fl;Lg;ghL

Immuni

za ions jLg;g{rpfs;

First

Aid

KjYjtp

Nutrition

al

Supplim

ents

Cl;lr; rj;J tH’;fy;

Medicine

s

kUe;J

General

Health

Education /

Advice

bghJ cly; eyf; fy;tp - mwpt[iu

Rank 1

nu’;f;; 1

Code FwpaPL

Rank 2

nu’;f;; 2

Code FwpaPL

Rank 3

nu’;f;; 3

Code

FwpaPL

Polio

nghypnah

Meas

les

jl;lk;ik

BCG

gprp$p DPT

ogpo

Q.no 628. 629. 630. 631. 632. 633. 634.

H6 N 01 02 03 04 05 06 07 08

01 02 03 04

E

H7 N 01 02 03 04 05 06 07 08

01 02 03 04

E

H8 N 01 02 03 04 05 06 07 08

01 02 03 04

E

H9 N 01 02 03 04 05 06 07 08

01 02 03 04

E

H10 N 01 02 03 04 05 06 07 08

01 02 03 04

E


Health facility Code Rfhjhu Rfhjhu Rfhjhu Rfhjhu trjpfs; FwpaPLtrjpfs; FwpaPLtrjpfs; FwpaPLtrjpfs; FwpaPL

Public Medical Sector

bghJ kUj;Jtj;Jiw

Private Medical Sector

jdpahh; kUj;Jtj;Jiw

Govt./Municipal Hospital

murh';f-Kdp!pgy; kUj;Jtkid

01 Private Hospital; jdpahh; kUj;Jtkid

13

Govt. Dispensary

murh';f kUe;jfk; 02 Private Doctor / Clinic

jdpahh; kUj;Jtu; - kUe;jfk; 14

UHV/UHP/UFWC

a[b\r;tp - a[b\r;gp - a[v`g;rplgps;a[rp 03 Private mobile clinic

jdpahh; bkhigy; kUe;jfk; 15

CHC/Rural Hospital/PHC

rpb\r;rp- fpuhkg;g[w kUj;Jtkid- Muk;g Rfhjhu ikak; 04 Ayurvedic doctor

[Vaidya/Hakim/Homeopath]

Ma[h;ntj kUj;Jth; (itj;jpau;-\f;fpk;-n\hkpnahgjp

16

Sub Centre Jiz ikak ; 05 Traditional Healer

ghuk;gupa itj;jpau; 17

Govt. Mobile Clinic

murh';f elkhLk; fpspdpf; 06 Pharmacy/ Dispensary

kUe;J fil-kUe;J tH’;Fkplk; 18

Camp Kfhk; (nfk;g;) 07 Dai (TBA)

brtpypj;jha; (ogpV) 19

Anganwadi/ICDS center m';fd;tho-Irpov!; brd;lh; 08 Other private sector health facility

kw;w jdpahh; Jiw Mnuhf;fpa trjpfs; 20

Other Public sector health facility

kw;w bghJj;Jiw Mnuhf;fpa trjpfs; 09 Other kw;wit 21

Other Government/ Public medical facility kw;w murh’;f-bghJ kUj;Jt trjpfs;

10

Don’t know bjupahJ 22

Don’t know bjupahJ 11

NGO or Trust Hospital/Clinic

vd;$pX my;yJ mwf;fl;lis kUj;Jtkid-fpspdpf; 12

Birth Control type

Options Code

Female sterilization bgz;fSf;fhd fUj;jil mWit rpfpr;ir

01

Male sterilization Mz;fSf;fhd fUj;jil mWit rpfpr;ir

02

Pills fUj;jil khj;jpiufs;

03

Injectables / Implants Crp K:yk; brYj;jg;gLtJ-clYf;Fs; bghUj;jg;gLtJ

04

IUD / Loop Ia[o- Y}g;

05

Condom Mqiw

06

Diaphragm (lnah`ghk;) bgz;fSf;fhd fUj;jil rhjdk;

07

Foam / jelly `nghk; - b$y;yp

08

Emergency contraception mtru fhy fUj;jil rhjdk;

09

Induced abortion J}z;lg;gl;l fUf;iyg;g[

10

Others (specify) kw;wit (Fwpg;gplt[k;)

11


Health: Staff and Facilities--all facilities INSIDE village Rfhjhuk; ? mYtyu;fs; kw;Wk; kUj;Jt trjpfs; ? fpuhkj;jpYs;s vy;yh kUj;Jt trjpfSf;Fk;

HE

ALT

H F

AC

ILIT

Y ID


Is the head

of this

facility a

medical

doctor? ,e;j

kUj;Jt ikaj;jpd; jiytu; xU kUj;Jt lhf;luh>

01 = yes

02 = no

01=Mk; 02=,y;iy

How

many

hours a

week

does this

head of

this

facility

work

here? ,e;j

kUj;Jt ikaj;jpd; jiytu; thuj;jpy; vj;jid kzp neuk; ,';F ntiy bra;fpwhu;>

Is the head

of this

facility a

resident of

this village?

,e;j kUj;Jt ikaj;jpd; jiytu; ,e;j

fpuhkj;jpy; trpg;gtuh>

If no

→ 6→ 6→ 6→ 633339999 01 = yes

02 = no

01=Mk; 02=,y;iy

If yes, give name

Mk; vdpy; . bgaiuf; Fwpg;gplt[k;

Number of full time staff

(don't include head) KG neu mYtyu;fspd; vz;zpf;if (jiytiur; nru;f;f ntz;lhk;)

Number of part time staff

(don't include head) gFjp neu mYtyu;fspd; vz;zpf;if

(jiytiur; nru;f;f ntz;lhk;)

How many

patients are

treated in this

facility in a

typical day?

xU ruhrup ehisf;F ,e;j

ikaj;jpy; vj;jid nehahspfs; rpfpr;ir

bgWfpwhu;fs;>

Number of

beds

available for

treatment

and delivery

rpfpr;ir kw;Wk;

gpurtj;jpw;F fpilf;Fk; gLf;iffspd; vz;zpf;if

Is every patient

that enters the

facility

examined by an

Medical Doctor

(MBBS / MD /

MS, etc)?

,e;j ikaj;jpw;Fs; EiHa[k; xt;bthU

nehahspiaa[k; lhf;lu;

gupnrhjpf;fpwhuh> 01 = yes

02 = no

01=Mk;. 02=,y;iy

Does the

facility

have

electricity?

,e;j ikaj;jpy; kpd;trjp cs;sjh>

01 = Yes

02 = No

01=Mk;. 02=,y;iy

Doctors

lhf;lu;fs; Nurses

eu;Rfs; Other F-T

employees

kw;w KGneu

gzpahsh;fs;

Doctors lhf;lu;fs;

Nurses eu;Rfs;

Other P-T

employees

kw;w gFjp neu

gzpahsh;fs;

Name

bgau; HH ID

FLk;g mil ahs vz;

Mem

ber

ID


M

ale

Mz;

Fem

ale

bgz

;

Male Mz;

Female bgz;

Q.no 635. 636. 637. 638. 639. 640. 641. 642. 643. 644. 645. 646. 647. 648.

H1 01 02

01 02

01 02 01 02

H2 01 02

01 02

01 02 01 02

H3 01 02

01 02

01 02 01 02

H4 01 02

01 02

01 02 01 02

H5 01 02

01 02

01 02 01 02

H6 01 02

01 02

01 02 01 02

H7 01 02

01 02

01 02 01 02

H8 01 02

01 02

01 02 01 02

H9 01 02

01 02

01 02 01 02

H10 01 02

01 02

01 02 01 02


Health: Staff and Facilities--all facilities within village (cont..) Rfhjhuk; ? mYtyu;fs; kw;Wk; kUj;Jt trjpfs; ? fpuhkj;jpYs;s vy;yh kUj;Jt trjpfSf;Fk; (bjhlu;r;rp)

HE

AL

TH

FA

CIL

ITY

ID

Rfhjhu trjpfs; milahs

vz;

Sunday

“hapW Monday

jp’;fs; Tuesday

brt;tha; Wednesday

g[jd; Total Hours

kept open

jpwe;jpUf;Fk; bkhj;j neuk; T

ime

op

en

jpwf;Fk neuk;

AM

fhiy

PM

khiy

Tim

e cl

osi

ng

K:Lk; neuk;

AM

fhiy

PM

khiy

Total Hours

kept open


ime

op

en

jpwf;Fk; neuk;

AM

fhiy

PM

khiy

Tim

e cl

osi

ng

K:Lk; neuk;

AM

fhiy

PM

khiy

Total Hours

kept open


ime

op

en

jpwf;Fk; neuk;

AM

fhiy

PM

khiy

Tim

e cl

osi

ng

K:Lk; neuk;

AM

fhiy

PM

khiy

Total Hours

kept open


ime

op

en

jpwf;Fk; neuk;

AM

fhiy

PM

khiy

Tim

e cl

osi

ng

K:Lk; neuk;

AM

fhiy

PM

khiy

649. 650. 651. 652. 653. 654. 655. 656. 657. 658. 659. 660.

H1 01 02 01 02 01 02 01 02 01 02 01 02 01 02 01 02

H2 01 02 01 02 01 02 01 02 01 02 01 02 01 02 01 02

H3 01 02 01 02 01 02 01 02 01 02 01 02 01 02 01 02

H4 01 02 01 02 01 02 01 02 01 02 01 02 01 02 01 02

H5 01 02 01 02 01 02 01 02 01 02 01 02 01 02 01 02

H6 01 02 01 02 01 02 01 02 01 02 01 02 01 02 01 02

H7 01 02 01 02 01 02 01 02 01 02 01 02 01 02 01 02

H8 01 02 01 02 01 02 01 02 01 02 01 02 01 02 01 02

H9 01 02 01 02 01 02 01 02 01 02 01 02 01 02 01 02

H10 01 02 01 02 01 02 01 02 01 02 01 02 01 02 01 02


H

EA

LT

H F

AC

ILIT

Y

ID

cly; ey trjpfs;

milahs vz; Thursday

tpahHd; Friday

bts;sp Saturday

rdp Total Hours

kept open

jpwe;jpUf;Fk; bkhj;j neuk;

Time

open

jpwf;Fk; neuk; A

M

fhiy

PM

khiy

Time

closing

K:Lk; neuk;

AM

fhiy

PM

khiy

Total Hours

kept open


Time

open

jpwf;Fk; neuk; A

M

fhiy

PM

khiy

Time

closing

K:Lk; neuk; A

M

fhiy

PM

khiy

Total Hours

kept open


Time

open

jpwf;Fk; neuk; A

M

fhiy

PM

khiy

Time

closing

K:Lk; neuk; A

M

fhiy

PM

khiy

Q. no 661. 662. 663. 664. 665. 666. 667. 668. 669.

H1 01 02 01 02 01 02 01 02 01 02 01 02

H2 01 02 01 02 01 02 01 02 01 02 01 02

H3 01 02 01 02 01 02 01 02 01 02 01 02

H4 01 02 01 02 01 02 01 02 01 02 01 02

H5 01 02 01 02 01 02 01 02 01 02 01 02

H6 01 02 01 02 01 02 01 02 01 02 01 02

H7 01 02 01 02 01 02 01 02 01 02 01 02

H8 01 02 01 02 01 02 01 02 01 02 01 02

H9 01 02 01 02 01 02 01 02 01 02 01 02

H10 01 02 01 02 01 02 01 02 01 02 01 02


HE

AL

TH

FA

CIL

ITY

ID


If a patient needs more specialized care than can be provided in [----facility], where is the patient generally referred?

xU nehahspf;F (?????kUj;Jt ikak;) ?y; yH’;ff;Toa kUj;Jt nritiatpl mjpf gpuj;jpnahfg; guhkupg;g[ njitg;gl;lhy; . bghJthf me;j nehahsp v’;F bry;y gupe;Jiuf;fg;gLfpwhh;>

Name of referred facility

gupe;Jiuf;fg;gLk; kUj;Jt ikaj;jpd; bgau;

village/town

fpuhkk;- efuk;

CENSUS

CODE

brd;!!; FwpaPL

Taluk

jhYf;fh

CENSUS

CODE

brd;!!; FwpaPL

District

khtl;lk;

CENSUS

CODE

brd;!!; FwpaPL

State

khepyk; CENSUS

CODE

brd;!!; FwpaPL

Distance

(KMs)

bjhiyt[ (fp/kPl;lupy;)

Q.no 670. 671. 672. 673. 674. 675.

H1

H2

H3

H4

H5

H6

H7

H8

H9

H10


Formal and Informal Financial Institutions for savings, credit, insurance nrkpg;g[ . fld; . fhg;gPl;ow;fhd Kiwahd kw;Wk; Kiwnrkpg;g[ . fld; . fhg;gPl;ow;fhd Kiwahd kw;Wk; Kiwnrkpg;g[ . fld; . fhg;gPl;ow;fhd Kiwahd kw;Wk; Kiwnrkpg;g[ . fld; . fhg;gPl;ow;fhd Kiwahd kw;Wk; Kiwg;g;g;g; gLj;jg;glhj epjp epWtd’;fs;gLj;jg;glhj epjp epWtd’;fs;gLj;jg;glhj epjp epWtd’;fs;gLj;jg;glhj epjp epWtd’;fs;

CODE/ TYPE

FwpaPL - tif Agency

epWtdk; […] In this village?

,e;j fpuhkj;jpy; […] cs;sjh> If yes, Number in this village ?

,e;j fpuhkj;jpy; cs;s vz;zpf;if � NEXT ROW

If None in village, distance of nearest to village/town (km.)

,y;iy vd;why; . mUfhikapy; cs;s Fwpg;gpl;l epWtdk;[ fpuhkj;jpy; - efuj;jpy; ,Ue;J vt;tst[ J}uk;>

Yes Mk; No ,y;iy

→→→→ 676767678888

Q.no 676. 677. 678.

1 Commercial Banks – Public Sector Bank (e.g., SBI)

tzpf hPjpapyhd t’;fpfs; ? bghJj;Jiw t’;fpfs; (cjhuzk; v!;gpI) 01 02

2 Commercial bank: Gramya banks (e.g.,RRBs)

tzpf hPjpapyhd t’;fpfs; ? fpuhkpa t’;fpfs; (cjhuzk; Mu;Mu;gp) 01 02

3 Commercial Bank – private commercial banks (ex: ICICI)

tzpf hPjpapyhd t’;fpfs; ? jdpahh; tzpf hPjpapyhd t’;fpfs; (cjhuzk; ? IrpIrpI)

01 02

4

Commercial Bank – Foreign Bank (ex: HSBC)

tzpf hPjpapyhd t’;fpfs; ? btspehl;L t’;fp (cjhuzk; b\r;v!;gprp) 01 02

6 Cooperative Commercial Bank Tl;Lwt[ tzpf t’;fp 01 02

7 Agricultural credit societies tptrhaf; fld; cjtp r’;f’;fs; 01 02

8 Non-agricultural credit societies tptrhak; my;yhj kw;w fld; cjtp r’;f’;fs; 01 02

9 Other credit societies kw;w fld; tH’;Fk; r’;f’;fs; 01 02

10 Insurance agent fhg;gpl;L Kftu; 01 02

11 Post Office m”;ry; epiyak; 01 02

12 Other (specify) kw;wit (Fwpg;gplt[k;) 01 02

Informal institutions Kiwrhuh epWtd’;fs; /;

13 Self help Groups (SHGs) Ra cjtp FGf ;fs ; 01 02

14 Micro Finance Institutions (MFIs) FW epjp epWtd’ ;fs ; 01 02

15 Other Non-banking financial institutions (like Nidhi companies, etc)

kw ;w t’ ;fprhuh epjp epWtd’ ;fs ; (cjhuzk ; epjp epWtd’ ;fs ; ,ju) 01 02

16 Professional money lenders tl;of;F gzk; bfhLg;gtu; 01 02

17 Chit funds rpl; `gz;L fk;bgdpfs; 01 02

18 Other informal institutions kw;w Kiwrhuh epWtd’;fs; 01 02


Details on each financial institution in village, or within walking distance of this village ,e;j fpuhkj;jpy; my;yJ ,e;j fpuhkj;jpypUe;J eil J}uj;jpy; cs;s epjp epWtd’;fs; xt;bthd;iwa[k; gw;wpa tpupthd jfty;fs;

Fin

anci

al i

nst

uti

tion

F

AC

ILIT

Y ID

epjp epWtdj;jpd; milahs vz;

LIST ALL INSTITUTIONS – Write

complete Name

vy;yh epWtd’;fisa[k; gl;oayplt[k; ? KGg; bgaiua[k; vGjt[k; [note: i. If there are 2 Commercial Banks

it would be listed as separate institutions

ii. If person, Record Name of the Person

and the Institution associated with]

(Fwpg;g[ ? 1 ) ,uz;L tu;j;jf t’;fpfs; ,Ue;jhy;;. jdpj;jdp epWtd’;fshf vGjt[k;/ 2) ? jdp egu; vdpy; mtupd; bgaiu Fwpg;gpl;L mtu; rhh;e;jpUf;Fk; epWtdj;ij Fwpg;gplt[k;

Type

CODE

(from

previous

page)

tifapd; FwpaPL (Ke;ija gf;fj;jpy; ,Ue;J) Refer Q

676

nfs;tp nfs;tp nfs;tp nfs;tp vz; 676 vz; 676 vz; 676 vz; 676 I I I I ghh;f;ft[k;ghh;f;ft[k;ghh;f;ft[k;ghh;f;ft[k;

GPS Reading

$p gp v!; fzf;bfLg;g[

Year of

establishment

Jtf;fg;gl;l tUlk;

YYYY

Name of highest

official or lender

caujpfhup my;yJ fld; bfhLg;gth; bgau;

If he

resides in

the same

village his

HH ID

mtu; ,nj fpuhkj;jpy; trpf;fpwhh; vdpy; FLk;g milahs vz;

MEMBER

ID

FLk;g cWg;gpdu; vz;

Is this

institution a

branch of

some other

institution

,e;j epWtdk; ntW epWtdj;jpd; fpisah>

Take

deposits

itg;g[ epjpfs; vLj;Jf; bfhs;sg; gLfpwjh>

Interest on

deposits (%)?

KjyPl;Lf;fhd tl;o (%)?

Give Loans.

fld;fs; jug;gLfpwjh>

Average

Interest on

Loans

(%)?

fld;fSf;fhd ruhrup tl;o (%)?

Yes

Mk;

No ,y;iy

Yes

Mk;

No ,y;iy →→ →→

68

8

Yes

Mk;

No ,y;iy

->N

EX

T R

OW

Q.no 679. 680. 681. 682. 683. 684. 685. 686. 687. 688. 689.

FI

N:

01 02 01 02

01 02

E:

F2

N:

01 02 01 02

01 02

E:

F3

N:

01 02 01 02

01 02

E:

F4

N:

01 02 01 02

01 02

E:

F5

N:

01 02 01 02

01 02

E:

F6

N:

01 02 01 02

01 02

E:


Fin

anci

al i

nst

uti

tion

F

AC

ILIT

Y ID

epjp epWtdj;jpd; milahs vz;

LIST ALL INSTITUTIONS – Write

complete Name

vy;yh epWtd’;fisa[k; gl;oayplt[k; ? KGg; bgaiua[k; vGjt[k; [note: i. If there are 2 Commercial Banks

it would be listed as separate institutions

ii. If person, Record Name of the Person

and the Institution associated with]

(Fwpg;g[ ? 1 ) ,uz;L tu;j;jf t’;fpfs; ,Ue;jhy;;. jdpj;jdp epWtd’;fshf vGjt[k;/ 2) ? jdp egu; vdpy; mtupd; bgaiu Fwpg;gpl;L mtu; rhh;e;jpUf;Fk; epWtdj;ij Fwpg;gplt[k;

Type

CODE

(from

previous

page)

tifapd; FwpaPL (Ke;ija gf;fj;jpy; ,Ue;J) Refer Q

676

nfs;tp nfs;tp nfs;tp nfs;tp vz; 676 vz; 676 vz; 676 vz; 676 I I I I ghh;f;ft[k;ghh;f;ft[k;ghh;f;ft[k;ghh;f;ft[k;

GPS Reading

$p gp v!; fzf;bfLg;g[

Year of

establishment

Jtf;fg;gl;l tUlk;

YYYY

Name of highest

official or lender

caujpfhup my;yJ fld; bfhLg;gth; bgau;

If he

resides in

the same

village his

HH ID

mtu; ,nj fpuhkj;jpy; trpf;fpwhh; vdpy; FLk;g milahs vz;

MEMBER

ID

FLk;g cWg;gpdu; vz;

Is this

institution a

branch of

some other

institution

,e;j epWtdk; ntW epWtdj;jpd; fpisah>

Take

deposits

itg;g[ epjpfs; vLj;Jf; bfhs;sg; gLfpwjh>

Interest on

deposits (%)?

KjyPl;Lf;fhd tl;o (%)?

Give Loans.

fld;fs; jug;gLfpwjh>

Average

Interest on

Loans

(%)?

fld;fSf;fhd ruhrup tl;o (%)?

Yes

Mk;

No ,y;iy

Yes

Mk;

No ,y;iy →→ →→

68

8

Yes

Mk;

No ,y;iy

->N

EX

T R

OW

Q.no 679. 680. 681. 682. 683. 684. 685. 686. 687. 688. 689.

F7

N:

01 02 01 02

01 02

E:

F8

N:

01 02 01 02

01 02

E:

F9

N:

01 02 01 02

01 02

E:

F10

N:

01 02 01 02

01 02

E:

F11

N:

01 02 01 02

01 02

E:

F12

N:

01 02 01 02

01 02

E:

social and political groups in village panel survey... · 66 village qustionnaire – part b...

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